Guide for Teachers 1
Children on Peritoneal Dialysis: Information for Teachers
Kidney Failure: Overview
This is the state in which the function of the kidneys is no longer able to deal with the body wastes which are produced daily through normal bodily function.
Accumulation of the waste products results in lethargy, poor appetite, poor growth, swelling of feet and general puffiness.
Problems associated with kidney failure
Anaemia: Kidney failure also results in chronic anaemia which makes them feel very tired. Never the less physical exercise should be encouraged within the limits of the childs abilities. With good treatment there should be no limitations on physical activity other than swimming and contact sports.
Falling Asleep in Class: This happens because of anaemia and if this happens the child should just be left to sleep and then encouraged to return to normal activity when they wake.
Tablets: Most children are required to take tablets with their lunch. The children should be responsible for their own medication, if of appropriate age. Teachers may need to remind the child until they get used to taking them by themselves. Teachers need to be aware of the medications, what they do, and when they should be taken to ensure the safety of other children, and parents should provide you with a list of the medications the child is on. This should be updated regularly.
Care of the Dialysis Tube: This must be kept clean and retained inside the childs clothing to prevent damage to it.
Complications of Peritoneal Dialysis
Infection inside the abdomen: An infection inside the abdomen (peritonitis) can cause abdominal pain, vomiting, general ill health, and diarrhoea. If this occurs, the Peritoneal Dialysis unit, and the childs mother or father, need to be contacted urgently. Phone 3072-833 (Peritoneal Dialysis Unit).
Diet: Children need to be encouraged to eat the food they have brought from home as they may be on a special diet.
Dialysis: Some children may need to dialyse at lunchtime due to the renal failure.
Definition of dialysis: This is a process of removing the waste products from a patient by putting special fluid into the abdomen and draining it out four times a day via a special tube which is surgically placed in their abdomen. These children are trained to do their own dialysis so it may only be performed by themselves and caregivers who have had special training in this procedure.
Infection Around the Tube: Sometimes the skin around the tube can become infected and this may be as a result of trauma ie pulling on the tube.
Headaches: Children with kidney failure and on dialysis may experience headaches. Children may have paracetamol to take for this and parents need to be contacted as this may be a sign of high blood pressure.
Fluid Retention or Puffiness: Some children may have too much fluid in their body and this will make them puffy or appear swollen and breathless. Some children may require a restricted fluid intake, to prevent this from happening.
Dizziness: Some children may experience dizziness as they have too little fluid resulting in a low blood pressure. This happens especially in summer.
Infectious Diseases: Children with kidney failure may have reduced immunity to infections eg chicken pox, and gastroenteritis. If there is an outbreak in the school, parents must be notified and the child may need to stay home from school.
Psychosocial Effects of Kidney Failure on Children
Poor growth, delayed puberty and the need for care in sports may lead to some social isolation or fears in been left behind by ones peers. Lethargy and hospital stays which can be lengthy may not just affect progress in normal school, but in a childs socialisation.
Education by a nurse trained in dialysis is available from the Peritoneal Dialysis Unit to talk to the teachers and class. Please phone: 3072-833 if you require any further information for teachers.
If you require someone to talk on anything to do with kidney disorders and how a hidden disability can affect children, then please phone 09 5344-055 and ask for Elaine Simons
Further information on End Stage Renal Failure is available from the Auckland District Kidney Society, on 09 2781-321.