What are vaccines?

A vaccine (or immunization) is a way to build your body’s natural immunity to a disease before you get sick. This keeps you from getting and spreading the disease.

Why are vaccines necessary?

Vaccinations are an essential part of the family and public health. Why? Because vaccines help prevent contagious, dangerous, and deadly diseases. These include influenza, Hepatitis B, chickenpox, measles, polio, mumps, HPV, etc.

Some illnesses like strains of cold viruses are relatively mild. But some, like COVID-19, smallpox, or polio, can cause life-altering changes. Sometimes leading to death. That’s why preventing your body from contracting these illnesses is very important.

Chronic kidney disease

Chronic kidney disease is the last stage of long-term, chronic disease. This is when the kidneys are no longer able to support your body’s needs.

So, if you are someone who is diagnosed with any renal disease, kindly go through the list of the vaccines recommended by doctors.

• Varicella vaccine
• MMR
• Influenza
• Pneumococcal Vaccination
• Hepatitis B

1. Varicella vaccine
   

   Until the varicella vaccine was licensed in 1995, chickenpox infection was very common. Almost everyone had been infected as a child. Now a vaccine is available to prevent chickenpox. Two doses of the vaccine are recommended for children, teens, and nonimmune adults.Complications can happen from chickenpox. They are more common in adults and people with weak immune systems. Complications may include.

   • Secondary bacterial infections
   • Pneumonia (lung infections)
   • Encephalitis (inflammation of the brain)
   • Cerebellar ataxia (defective muscular coordination)
   • Transverse myelitis (inflammation along the spinal cord)
   • Reye syndrome. This is a serious condition marked by a group of symptoms that may affect all major systems or organs. Do not give aspirin to children with chickenpox. It increases the risk for Reye syndrome.
   • Death

2. MMR Vaccine
   

   Measles can be prevented with the MMR vaccine. The vaccine protects against three diseases: measles, mumps, and rubella. MMR vaccine protects against four diseases: measles, mumps, rubella, and varicella (chickenpox). This vaccine is only licensed for use in children 12 months through 12 years of age.CDC recommends that children get one dose of MMRV vaccine at 12 through 15 months of age, and the second dose at 4 through 6 years of age. Children can receive the second dose of MMRV vaccine earlier than 4 through 6 years. This second dose of MMR vaccine can be given 3 months after the first dose.

   Children*	Age 12-15 months	Age 4-6 years
   Teenagers and adults with no evidence of immunity**	As soon as possible	N/A

   Benefits of MMR vaccine:

   1. Prevents measles: Measles is a very contagious disease caused by a virus. It spreads through the air when an infected person coughs or sneezes.
   2. It is safe and effective: Two doses of MMR vaccine are about 97% effective at preventing measles; one dose is about 93% effective.

   Two doses of MMR vaccine are 97% effective against measles and 88% effective against mumps.

3. Influenza (Flu) vaccine
   

   Influenza (flu) vaccines (often called “flu shots”) are vaccines that protect against the four influenza viruses that research indicates are most common during the upcoming season. Most flu vaccines are “flu shots” given with a needle, usually in the arm, but they’re also is also a nasal spray flu vaccine.

   1. Who should get a flu vaccine?
      Everyone 6 months of age and older should get Influenza (flu) vaccine every season with rare exceptions. CDC’s Advisory Committee on Immunization Practices has made this recommendation since the 2010-2011 flu season.Vaccination to prevent flu and its potentially serious complications is particularly important for people who are at higher risk of developing serious flu complications.
   2. Why should you get vaccinated for Influenza?
      Influenza (flu) vaccine effectiveness (VE) can vary. The protection provided by a flu vaccine varies from season to season and depends in part on the age and health status of the person getting the vaccine and the similarity or “match” between the viruses in the vaccine and those in circulation. During years when the flu vaccine match is good, it is possible to measure substantial benefits from flu vaccination in terms of preventing flu illness and complications. However, the benefits of flu vaccination will still vary, depending on the characteristics of the person being vaccinated (for example, their health and age), what influenza viruses are circulating that season, and, potentially, which type of flu vaccine was used.

4. Pneumococcal Vaccination:
   

   Pneumonia is a severe form of acute lower respiratory tract infection. The lungs are made up of small sacs called alveoli, which fill with air when a healthy person breathes. When an individual has pneumonia, the alveoli are filled with pus and fluid, which makes breathing difficult and limits oxygen intake. Severe pneumonia or sinusitis can progress to bacteremia/sepsis or meningitis, which require antibiotic treatment and have high mortality rates. DIFFERENT TYPES OF DISEASES CAUSED BY PNEUMOCOCCUS
   Diseases caused by pneumococcus (Streptococcus pneumonia) are a major public health problem worldwide. Diseases that are often caused by pneumococcus

   • Pneumonia: inflammation of the lungs;
   • Bacteremia/sepsis: bloodstream infection, with or without infection of secondary sites, e.g., meningitis;
   • Bacterial meningitis: infection of the membranes that cover and protect the spinal cord and brain;
   • Otitis media: Middle ear infection; and
   • Sinusitis, Bronchitis
     

   About 75% of invasive pneumococcal disease and 83% of pneumococcal meningitis occur in children aged <2 years, among which many cases occur in neonates and children under 6 months of age
   

   Prevention:

   Preventing pneumococcal diseases, particularly pneumonia, in children is an essential component of a strategy to reduce child mortality. Immunization against Hib, pneumococcus, measles and whooping cough (pertussis) is the most effective way to prevent pneumonia. Adequate nutrition is the key to improving children’s natural defenses, starting with exclusive breastfeeding for the first 6 months of life. In addition to preventing pneumonia, it also helps reduce the length of the illness, if a child does become ill. Addressing environmental factors such as indoor air pollution (by providing affordable clean indoor stoves, for example) and encouraging good hygiene in crowded homes also reduces the number of children who fall ill with pneumonia.

5. Hepatitis B
   

   It is a serious disease caused by a virus that attacks the liver. The virus, which is called hepatitis B virus (HBV), can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death.

   The Hepatitis B vaccine is available for all age groups. The hepatitis B vaccine is recommended for all infants, all children or adolescents younger than 19 years of age who have not been vaccinated, all adults aged 19 through 59 years, and adults age 60 years or older with risk factors for hepatitis B infection. Adults who are 60 years or older without known risk factors for hepatitis B may also receive the hepatitis B vaccine.

   If you have any concerns regarding vaccination or renal diseases in general, kindly reach out to us and the help you need.

Resources

Immunizations in patients with end-stage kidney disease – UpToDate

End-stage kidney disease: MedlinePlus Medical Encyclopedia

Measles, Mumps, and Rubella (MMR) Vaccination | CDC

Chickenpox | Johns Hopkins Medicine

About Shingles (Herpes Zoster) | CDC

What is nephrotic syndrome in children?

Nephrotic syndrome is a condition that causes the kidneys to leak large amounts of proteins into the urine. Think of it as a colander with big holes. This can lead to many problems, including swelling of body tissues and a greater chance of catching infections.

1. How common is nephrotic syndrome in children?
   Around 1 in every 50,000 children are diagnosed with the condition every year.It tends to be more common in families with a history of allergies or those of Asian background, although it’s unclear why.

When protein spills into the urine, this can cause:

• Swelling
  • The low level of protein in the blood reduces the flow of water from the body tissues back into the blood vessels, leading to swelling.Swelling is usually first noticed around the eyes, then around the lower legs and the rest of the body.
• Tiredness
  • Feeling fatigued and not having the energy to do regular activities. Any chronic illness can make one feel extremely tired.
• Loss of appetite
  • Too much protein escaping into the urine leaves a lack of protein in the blood which can result in malnutrition and change your perception of certain foods.
• Infections
  • Antibodies are a specialized group of proteins in the blood that help to fight infection. When these are lost, children are much more likely to get infections.
• Urine changes
  • Occasionally, the high levels of protein being passed into the urine can cause it to become frothy. Some children with nephrotic syndrome may even pass less urine than usual during relapses.

STUDIES SUGGEST A COMPLEX SET OF FACTORS ARE INVOLVED THAT CAUSE NEPHROTIC SYNDROME IN CHILDREN

What can we expect with early diagnosis and proper medication?

1. 93% of children respond well to steroids
2. 85% of children become disease-free during childhood
3. Relapses are common: 74% of the children who respond will relapse within 5 months

Some essential vaccinations:

• Children with nephrotic syndrome are advised to have pneumococcal vaccines.
• Some children may also be recommended varicella. (chickenpox)

How do health care professionals diagnose nephrotic syndrome in children?

Nephrotic syndrome in children is diagnosed with

• a medical and family history
• a physical exam
• urine tests, to look for excess urine proteins
• blood tests, to test kidney function and to look for underlying diseases

Additional tests to identify the cause of nephrotic syndrome may include

• Ultrasound of the kidney
• Kidney biopsy
• Genetic testing

Many children with nephrotic syndrome will not need a kidney biopsy. The test is usually reserved for children who have the complex disease, who have low kidney function, or who are 12 years old or older.

1. What else should one know about nephrotic syndrome in children?
   Minimal change disease causes most cases of nephrotic syndrome in kids. Those who get prednisone usually respond well, and the problem goes away by the time they’re teens. In the meantime, kids might need to take medicines for a few months or more.
   Sometimes, a child will have a relapse. This means the nephrotic syndrome comes back after going away. In this case, treatment starts again until the child outgrows the condition or it improves on its own.
   The sooner treatment for the nephrotic condition starts, the better. If your child shows any signs of the condition, call your doctor so it can get checked out right away.

References:

Nephrotic Syndrome in Children | NIDDK

Nephrotic Syndrome – Johns Hopkins All Children’s Hospital

Nephrotic Syndrome | Treatment, Diet, & Common Questions | Buoy