KARACHI, Oct 19: Speakers at the Kidney Foundation symposium on Saturday deplored the fact that the facility of continuous ambulatory peritonal dialysis — a treatment in which a patient can dialyze himself at home without needing a machine — was not available in the country.

The two-day symposium, which is being conducted by the Kidney Foundation, is titled “Excellence in dialysis — update in nephrology”.

Speaking on the subject of renal diseases in children of Pakistan, Afroze Ramzan Sherali of the National Institute of Child Health said there was a wide range of conditions that affected the kidneys of children varying from congenital malformations, inherited diseases and acquired diseases.

“Children are not to be viewed as small adults but as a section of the population with its own range of diseases and requirements. In this age group there is greater interaction of disease with growth and development and psychological aspect of disease. In the more developed countries major advances have been made in the understanding of molecular basis of renal disease, particularly the congenital abnormalities and the genetically determined disorders.”

The child specialist spoke about an analysis of 2015 children of one month to 15 years with renal problems during a ten years period (1989-1999) which had been carried out at the National Institute of Child Health to see the pattern of renal diseases. “1,420 (70.48 per cent) boys and 595 (29.52 per cent) girls had renal problems with a male to female ratio 2.3:1. Children having nephrotic syndrome were 863 while 350 had congenital renal diseases.”

Ms Sherali said the old renal problems were still prevalent, provision of proper management of renal replacement therapy was grossly inadequate and expensive and there was still high incidence of malnutrition, infectious diseases, diarrhoea and pneumonia. “Though this may not be the true reflection of national pattern of renal disease, yet it gives useful information. Nephrotic syndrome is the most common renal disease followed by congenital renal disease. Urinary calculi, CRF, UTI, AGN and ARF are other important renal diseases in this country.”

The chief executive of the Kidney Foundation, Prof S.A. Jaffar Naqvi, stressed the usefulness and efficacy of the continuous ambulatory peritoneal dialysis. He said: “This is unfortunate that the health sector has not received the attention that it deserves in our country. The government is spending 0.6 per cent of the GNP on the health sector.”

Rasib Raja of the Jefferson Medical College, Philadelphia, spoke on the subject of “Current management of diabetic nephrology.” He said: “Diabetes is the leading cause of end-stage renal disease in the United States and its prevalence is increasing rapidly throughout the world. About 20-30 per cent of diabetics develop diabetic nephropathy. Native Americans, Hispanics and African Americans are at higher risk than non-Hispanic whites.”

Others who spoke on the occasion were Dr Harun-ur-Rashid of Bangladesh, Prof Akhter Ali, Brig Shaheen Moin, Brig S.A. Saleem, Dr Manohar Lal, Dr Zahid Pervaiz and Dr Nisar Anwar.