Maintain Kidney Health In Children

Kidney function in the body

The kidneys are two oval, bean-shaped organs located at the back of the abdominal cavity. The size of an adult kidney is generally 3 cm thick, 6 cm wide, and about 11–12 cm long. The internal structure of the kidney will grow and develop until the age of 6–12 years, while the development of the outer structures and blood vessels of the kidney will stop at the age of 17–21 years. The two kidneys are responsible for filtering toxins, removing digestive wastes (urea and creatinine), and balancing electrolyte levels such as sodium and potassium in the bloodstream. The kidneys also produce hormones that regulate blood pressure and stimulate the production of red blood cells. Although the size of the kidney is relatively small, it has a very important function.

Some of the important functions of the kidney include :

• Digestive Waste Removal: Kidneys help filter waste products and toxins from the body, including excess electrolytes and nitrogenous waste products such as urea. These wastes are then excreted from the body through urine.
• Regulates Electrolyte Balance: Kidneys help maintain electrolyte balance in the bloodstream. The kidneys will reabsorb electrolytes such as sodium and potassium as needed and excrete excess electrolytes in the urine.
• Regulation of Blood Pressure: The kidneys produce hormones that help regulate blood pressure by contracting or dilating blood vessels.
• Production of Red Blood Cells: The kidneys produce a hormone called erythropoietin (EPO), which helps stimulate the production of red blood cells in the bone marrow.
• Production of Vitamin D: The kidneys produce the active form of Vitamin D, which helps regulate blood levels of calcium and phosphorus, which are essential for bone health.
• Maintain Blood Acidity: The kidneys are responsible for maintaining the homeostasis of hydrogen ions (H+) and bicarbonate ions (HCO3-) in the blood. The kidneys can form bicarbonate ions and excrete hydrogen ions to regulate the acid-base balance in the body.

The role of the kidney in drug metabolism

The pharmacokinetic process of drugs in the body can be divided into several stages, including absorption, distribution, metabolism, and excretion. The liver and kidney are two organs that play a role in drug metabolism. Drug metabolism is the process by which drugs and other foreign substances are broken down by the body's enzymes. Most of the drugs are metabolized by the liver, while only certain drugs are metabolized by the kidneys. The liver will either break down the drug into an active form or break it down into simpler metabolites. The kidneys play a role in excreting drugs and their metabolites from the body through urine. The kidneys help break down the drug into its active components and excrete the remaining drug metabolites in the urine. The kidneys also help maintain certain drug concentrations in the blood and express them when the drug is no longer needed by the body.

How to keep the kidneys healthy

• Stay hydrated (drink enough): Encourage your child to drink enough water throughout the day to avoid dehydration.
• Consume a well-balanced diet: To maintain healthy kidney function, ensure that your child consumes a well-balanced nutritional diet that includes fruits and vegetables.
• Exercise regularly: Adequate and regular physical activity can help maintain kidney function.
• Avoid exposure to secondhand smoke: Teach your child to avoid secondhand smoke, as secondhand smoke can increase the risk of kidney disease.
• Avoid alcohol: Teach your child not to drink alcohol (especially among teenagers), as alcohol can cause serious damage to the kidneys.
• Check medicines according to medical indications: Make sure any medicine your child is taking has first been consulted with a medical professional (doctor) and does not cause kidney problems.

Impaired kidney function can be detected by certain physical and laboratory examinations. The medical team can assess kidney health or detect kidney disorders in patients and plan treatment. Parents can immediately consult a doctor at the nearest Hermina Hospital, and Friends of Hermina can also consult online with specialist doctors through the "Halo Hermina" application.

Referensi:

1. Aizman RI. Age Transformations of the Kidneys Structure and Function. Heal Educ Public Heal. 2019;2(3):195–8.

2. Garza A, Park S, Kocz R. Drug Elimination. In: StatPearls [Internet] Treasure Island (FL) [Internet]. StatPearls Publishing; 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547662/

3. Nolin TD. Drug Metabolism in Kidney Disease. In: Drug Metabolism in Diseases. 2017. p. 91–113.