Paediatric Kidney Disease: An Overview

Dr.Neha Bhandari, 5 mins read

Kidneys are vital organs for our overall well-being. They work as a filter to remove waste from the blood and supply the cleaned blood back to the body. They are bean-shaped organs located on each side of the spine and below the rib cage. Kidneys also aid in blood pressure regulation, red blood cell production and maintaining the level of electrolytes in the body. 

But when kidneys don’t function properly, the condition is labelled as kidney disease. This condition can affect both adults and children. Kidney disease primarily has two types:

• Acute kidney disease: This condition occurs when the kidney stops functioning suddenly. It can happen in a matter of a few hours or days. However, getting timely treatment may make the kidneys work again.
• Chronic kidney disease (CKD): This condition is characterised by loss of kidney function over several years. A kidney disease that lasts for more than three months is known as CKD.
  

Symptoms

The symptoms of acute and chronic kidney disease in children may be different.  

Symptoms of acute kidney disease in children:

• Rash
• Fever
• Pale skin
• Stomach pain
• Severe vomiting
• No or a lot of urine
• Bloody diarrhoea
• Inflammation in the eye
• Bleeding (haemorrhage)
• Decreased Urine
• Pain while passing urine
• Increased urine output

Symptoms of chronic kidney disease may include:

• Nausea
• Fatigue
• Vomiting
• Headache
• Dry, itchy skin
• Muscle cramps
• Stunted growth
• Bad breath
• Pale skin
• Hearing problem
• Irritability
• Sleep problems
• Loss of appetite
• High blood pressure
• Less or more urination
• Swelling in feet and ankle
• Change in mental sharpness
• Chest pain
• Shortness of breath

Causes

• Birth defects - like missing one or both kidneys (renal agenesis), kidneys are not developed properly (kidney dysplasia) and having kidneys with fewer nephrons than normal (renal hypoplasia).
• Infections - such as hemolytic uremic syndrome (damage or inflammation to small blood vessels in the kidney) and post-streptococcal glomerulonephritis (antibodies produced by the immune system deposit in the kidney and cause damage).
• Hereditary diseases - like polycystic kidney disease (development of fluid-filled cysts in the kidney) and Alport syndrome (a problem that affects the outer lining of the kidney cells).
• Nephrotic syndrome - a kidney disease in which glomeruli (tiny filters in the kidney) become inflamed and damaged. This leads to protein leakage from the blood into the urine.
• Systemic disease - a disease that affects many organs or the entire body.
• Trauma - like bleeding, injury, dehydration and surgery, may decrease the flood flow to the kidneys.
• Urinary blockage or reflux - a blockage between the kidneys and urethra is called a urinary blockage. This leads to kidney damage. Reflux occurs when the valve between the ureter and kidneys doesn’t work appropriately. This allows the urine to flow back to the kidneys from the bladder.

Diagnosis

The doctor will first ask about your child’s symptoms and health history. If the doctor finds anything unusual, he may conduct a few tests:

• Blood test: This helps to check the child’s blood cell counts, kidney function and electrolyte levels.
• Urine test: This test helps to check the protein and blood in the urine and other conditions.
• Sonography: Your doctor conducts this exam to see the size and shape of your child’s kidney. It’s a painless procedure done through sound waves. These sound waves help to create the kidney image on the computer screen. Using sonography, the doctor can also see growth, cysts, kidney stones and other problems.
• Biopsy: In this test, a small sample of kidney tissue is taken and evaluated in a laboratory.

Treatment

If your child is diagnosed with kidney disease, immediately consult a paediatric nephrologist. The treatment depends on the child’s severity, age and overall health and what kind of kidney disease your child has. 

The doctor first treats and controls the underlying problem causing the kidney damage. Children with acute kidney disease may be asked to:

• Change their diet
• Get medicines to improve the urine production
  
• Closely monitor electrolytes like potassium, calcium and sodium
  
• Take medicines to control blood pressure
  
• Get IV (intravenous) fluids to replenish fluid loss
  

Sometimes children with acute kidney disease may need dialysis and hospital admission. Dialysis will filter waste and extra fluids from the blood until the kidney recovers.

Those with chronic kidney disease may need:

• Dialysis
• Dietary changes
  
• Medicines to improve the amount of urine made
  
• Kidney transplant - a procedure to replace the damaged kidney with a healthy one.
  

Also, Read: Chronic Kidney Disease in Children