Kidney Disease in Children

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Kidney Disease in Children

The kidneys play a critical role in the body: Acting as the body's filtering system, they help control water levels and eliminate wastes through urine. They also help regulate blood pressure, red blood cell production, and the levels of calcium and minerals.

Symptoms of Kidney Diseases in Children :

  • Burning sensation during urinating, Urinating more often or less often,Bedwetting at night, Blood in urine, Protein leakage in urine
  • Swelling around the eyes, face, feet, and ankles
  • Stunted or poor growth as compared to similar age group peers
  • Lethargy and fatigue
  • Legs bend inward toward each other or outward away from each other
  • Headache and High Blood Pressure

Kidney disease can affect children in various ways, ranging from treatable disorders without long-term consequences to life-threatening conditions.

Acute kidney disease develops suddenly, lasts a short time, and can be serious with long-lasting consequences or may go away completely once the underlying cause has been treated.

Chronic kidney disease (CKD) does not go away with treatment and tends to get worse over time. CKD eventually leads to kidney failure, described as end-stage kidney disease or ESRD when treated with a kidney transplant or blood-filtering treatments called dialysis.

kidney diseases in children are seen in various ways

Many disorders are due to congenital malformation of urinary tract (kidney, ureter, bladder) that happens while a baby is developing in the mother’s womb. With the help of prenatal sonography many problems can be diagnosed even before the birth of baby and early intervention immediately after birth will prevent damage to the kidneys.

  • Blockage of urinary tract
  • The blockage is caused when there is a narrowing of area between the ureter and the part of the kidney called the renal pelvis. (Uretero-pelvic junction (UPJ) obstruction)
  • Posterior Urethral Valves (PUV), means that the male child born with extra flaps of tissue that have grown in his urethra, the tube that leads from the bladder to the tip of his penis. These extra flaps of tissue block the normal flow of urine, which can damage organs such as the bladder and kidneys
  • Backward flow of urine from the bladder into the kidneys. (Vesico-ureteral reflux)
  • Born with only one kidney. ( Renal Agenesis)
  • Multi-cystic dysplastic kidney (MCDK) or Polycystic Kidney Disease is a condition that results from the malformation of the kidney during fetal development. The kidney consists of irregular cysts of varying sizes.

Nephrotic Syndrome

Nephrotic syndrome is a condition which causes the kidneys to leak large amounts of protein into the urine. This can lead to swelling of body tissue. It starts with swelling around eyes in the morning and reduces as the day progresses. If untreated, swelling of whole body develops.

Nephrotic syndrome is treatable, but as this disease may relapse , proper treatment is very important. In most cases, relapses become less frequent as they get older and often stop by their late teens. If protein continues to leak , it may damage kidneys. Doctors usually prescribe a medicine called immuno-suppressants which has many side effects. It is advisable to continue the treatment under supervision of a Nephrologist.

Urinary Tract Infection

Urinary Tract Infection is a bacterial infection of the urinary bladder (cystitis) or the kidneys (pyelonephritis).

  • Newborns and infants may have no symptoms other than a fever, whereas older children have pain or burning during urination, pain in the bladder region, and a need to urinate frequently.
  • The diagnosis is based on an examination of the urine. Antibiotics are given to eliminate the infection.
  • Proper hygiene may help prevent UTIs.

Younger infants and children who have UTIs, however, more commonly have various structural abnormalities of their urinary system that make them more susceptible to urinary infection. These abnormalities include vesico-ureteral reflux (urine to pass backward from the bladder up to the kidney) and a number of conditions that block the flow of urine. As many as 50% of newborns and infants with a UTI and 20 to 30% of school-aged children with a UTI have such abnormalities. If not diagnosed early and recurrent UTI may lead to kidney damage and hypertension in child.

Bending of Bones ( Rickets) :

Rickets is a disorder caused by a lack of vitamin D, calcium, or phosphate. It leads to softening and weakening of the bones. Usually rickets is treated by giving vitamin D, but when it is not treated after a course of vitamin D, in majority it is due to kidney problem like kidney failure or tubular disease (renal tubular acidosis). So in such a case proper investigations and diagnosis will help to prevent bone deformity in child.

Tubular disease of kidneys:( Renal tubular acidosis, Bartter syndrome, Diabetes incipidus)

In these disorders, children tend to pass more urine and drink more water. They have poor growth. Few of children may require repeated hospitalization due to dehydration and electrolyte imbalance. Proper diagnosis on time leads to normal growth and prevent further complications.

Stone in Urinary Tract :

Kidney stones are small, hard deposits of mineral and acid salts formed within the urinary tract. There are many different kinds of stones, with calcium oxalate and calcium phosphate stones being most common. There are other less common types of kidney stones.

The stone can cause pain, block the flow of urine, and, rarely, can cause long-term kidney problems if it is not recognized and treated promptly. Stones are less common in children than in adults. Most children who develop kidney stones have an underlying condition that increases their risk of stones. These conditions are either metabolic abnormalities ( increased mineral excretion in urine) or tubular disease of kidneys. So proper investigations and treatment prevent recurrent stone formation.

Remember, child kidney is not a miniature of adult kidney and so the disease spectrum and management. You need a Child Kidney Specialist who can effectively manage these growing children.

Pediatric Nephrologist