Experts call for - kindergarten, primary and secondary school physical examination can not be no urine routine
In the Beijing Children's Hospital blood purification center, there are a group of children from all over the country, due to chronic kidney failure, they must rely on three times a week hemodialysis treatment to maintain life.
Yesterday, a reporter investigated and found that the routine urine test, which is considered by kidney disease experts as the most effective "alarm" for kidney disease, has been neglected in children. The city's kindergarten and primary and secondary school admission, physical examination, as well as the annual routine physical examination, there is no urine routine this one. Coupled with the lack of relevant medical knowledge of parents, many children in the early stages of kidney disease are not detected in time, and therefore miss the best time for treatment.
Children with kidney disease
Increasing at a rate of 13% per year
Yesterday, in the blood purification center of the Beijing Children's Hospital, a dozen or so "little sickies" ranging from a few years old to teenagers were undergoing a four-hour hemodialysis session at a cost of about 500 yuan. Because of chronic kidney failure, they look thinner than children their own age.
Patient Wang Xiaobo, 12, can't stand the long hours of dialysis, and falls asleep. The dialysis machine next to his bed is working softly, as crimson blood slowly circulates through transparent tubing. The machine's lines are relatively thin, and the cylindrical dialyzer that filters excess water and toxins from the blood is relatively small. Nonetheless, the set of supplies is still of adult standard, and Wang Xiaobo is barely able to use it.
A data shows that from 2000 to the present, China's children with kidney disease at an annual rate of 13% increase. And now known chronic kidney disease patients, many adults with kidney disease began in childhood.
In the interview, the reporter found that children's kidney disease is a kind of disease that is not easy to be detected early.
The Beijing child Qiaoqiao is 12 years old and has been on dialysis for six years. His mother, Ms. Liang, said that at first, just found that the child does not love to eat, sometimes vomiting, when the spleen and stomach disease treatment, the results did not expect is a kidney problem.
Ningxia to 'Wang Jianhui is January 19 this year, because of suspected anemia hospitalized, only to find kidney failure, and then sent to Beijing Children's Hospital treatment. His mother, Ms. Chai, regretted, "I saw him pale, thought it was anemia. I did not expect it to be such a serious disease, but there is no local hospital to do children's dialysis."
Kindergarten, primary and secondary schools
No urine test in the physical examination program
Li Yuehong, director of the Department of Nephrology at Tsinghua Changgeng Hospital in Beijing, told the reporter that children's kidney disease is not scary to begin with, and it can usually be cured if treatment is given in time. Therefore, whether it is congenital or acquired kidney disease, the most important thing is early detection and early treatment. "Urine routine, there are urine protein, urine white blood cells, urine red blood cells and other indicators, the emergence of positive suggests the possibility of kidney urinary system disease." Li Yuehong said, usually regular testing of children's urine, you can find most of the early signs of kidney disease.
In recent years, kidney disease experts have repeatedly issued a "urine routine check into the kindergarten, primary and secondary school physical examination program" call. However, the reporter learned that the Beijing Municipality and even the national physical examination did not specify this test.
This year's 3-year-old Xixi on a private kindergarten in the city. Asked about the physical examination of the kindergarten there is no urine check, her mother Ms. Zhang froze, "No ah, so small children do not need to check the urine, right?" Similarly, the child has been in elementary school Mr. Dou recalled that his child from public kindergarten until elementary school have not been tested for urine, "We generally pay attention to the child's internal organs and blood tests for any problems."
Why is urine routine not taken seriously? The reason is that the state does not have a clear regulation. Beijing Maternal and Child Health Hospital children's health section director Kong Yuanyuan revealed in an interview with reporters, the city's admission to the physical examination program in accordance with the National Health and Planning Commission issued by the "nursery school kindergarten health care work norms" implementation. The norms mentioned that children should be enrolled in child care institutions before the health examination by medical and health institutions, qualified before entering the park (Institute). In the health checklist for children to enter kindergartens (institutes), there are requirements for height, weight, oral cavity, skin, heart, lungs, liver, spleen, spine, external genitalia, as well as testing of blood, except for routine urinalysis. In addition, the reporter inquired about the current "primary and secondary school students health examination management approach" found that the urine routine is also not included in the physical examination of primary and secondary school students.
"As a nephrologist, I sincerely hope that parents can pay attention to their children's routine urinalysis, kindergartens and primary and secondary schools can also take the urine test as a routine annual physical examination should be examined." Li Yuehong said.
News extension
Adult equipment for children's kidney dialysis
"Since the domestic market currently has no adapted special dialyzers and tubing, children who are too young for dialysis can only be treated with peritoneal dialysis." Yesterday, Beijing Children's Hospital Professor Shen Ying told reporters that due to the lack of equipment conditions, domestic children's kidney dialysis can only use adult dialysis equipment and refer to adult dialysis standards.
Wang Jianhui from Ningxia, just one month after elementary school, was diagnosed with chronic kidney failure. On the hospital bed, he dialyzed blood while being transfused. Beijing Children's Hospital nurse Ma Junmei explained, the existing dialyzer and tubing for him are too large size, blood are pumped out of the dialysis, is likely to lead to a rapid decrease in his blood pressure, and even shock, so also have to be transfused to replenish the amount of blood in the body.
"Dialyzers and tubing for children should be child-sized. Otherwise, the dialysis effect will also be discounted." Ma Junmei said.
Why do children use adult equipment for kidney dialysis? The reporter learned that the demand for children with chronic renal failure is relatively small compared to adults, and domestic manufacturers are reluctant to produce children's dialysis equipment. The company's main goal is to provide the best possible service to its customers," he said.
Prof. Ying Shen and her team found that less than 50% of children with chronic kidney failure in China can receive kidney dialysis due to family finances and hospital equipment, and that the level of dialysis treatment for children is at least 20 years behind that for adults.