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Overview of Kidney Disease in Children

What is kidney disease in children?

Kidney disease (renal failure) refers to temporary or permanent damage to the kidneys that results in loss of normal kidney function. There are 2 different types of renal failure — acute kidney disease and chronic kidney disease. Acute kidney disease is further divided into acute and subacute injury. Acute kidney disease starts suddenly and might be able to be reversed. Chronic kidney disease gets worse slowly over at least 3 months. It can lead to permanent renal failure. The causes, symptoms, treatments, and outcomes of acute and chronic kidney disease are different.

Conditions that may lead to acute or chronic kidney disease may include:

Acute kidney disease

Chronic kidney disease

Less blood flow to the kidneys for a period of time. This may occur from blood loss, surgery, or shock.

A long-lasting blockage in the urinary tract.

A blockage along the urinary tract.

Alport syndrome. This is an inherited disorder that causes deafness, progressive kidney damage, and eye defects.

Hemolytic uremic syndrome. This is usually caused by an E. coli infection. Kidney failure develops because small structures and vessels in the kidney are blocked.

Nephrotic syndrome. This condition has several different causes. Symptoms of nephrotic syndrome include protein in the urine, low protein in the blood, high cholesterol levels, and tissue swelling.

Taking certain medicines that may cause kidney problems.

Polycystic kidney disease. This is a genetic disorder where many cysts filled with fluid grow in the kidneys.

Glomerulonephritis. This is a type of kidney disease that involves glomeruli. During glomerulonephritis, the glomeruli become inflamed and harm how the kidney filters urine.

Cystinosis. This is an inherited disorder in which the amino acid cystine collects within certain cells in the kidney called lysosomes.

Any condition that may slow or block the flow of oxygen and blood to the kidneys, such as cardiac arrest.

Chronic illnesses such as diabetes or high blood pressure. If these illnesses aren't treated, less oxygen and blood can get to the kidneys.

Acute kidney disease may progress to chronic kidney disease if not treated.

What are the symptoms of kidney disease in a child?

The symptoms for acute and chronic kidney disease may be different. The following are the most common symptoms of acute and chronic kidney disease. But symptoms may be a bit different for each child.

Acute signs and symptoms

Symptoms of acute kidney disease depend largely on what is causing the condition.

  • Bleeding (hemorrhage)

  • Fever

  • Rash

  • Bloody diarrhea

  • Severe vomiting

  • Stomach pain

  • No urine or lots of urine

  • Pale skin

  • Swelling of the tissues

  • Inflammation of the eye

  • Stomach mass

Chronic signs and symptoms

  • Poor appetite

  • Vomiting

  • Bone pain

  • Headache

  • Stunted growth

  • Malaise

  • Lots of urine or no urine

  • Repeated urinary tract infections

  • Urinary incontinence

  • Pale skin

  • Bad breath

  • Hearing problems

  • Stomach mass

  • Tissue swelling

  • Irritability

  • Poor muscle tone

  • Change in mental alertness

The symptoms of acute and chronic kidney disease may look like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is kidney disease diagnosed in a child?

In addition to a physical examination and complete medical history, your child's health care provider may order the following diagnostic tests:

  • Blood tests. Blood tests will find out blood cell counts, electrolyte levels, and kidney function.

  • Urine tests

  • Renal ultrasound (sonography). n this noninvasive test, the provider moves a transducer over the kidney. This sends a picture of the kidney to a video screen. This test is used to see the size and shape of the kidney, and to find a mass, kidney stone, cyst, or other problems.

  • Renal biopsy. For this test, the provider takes a sample of tissue with a needle or during surgery. The sample is looked at under a microscope.

How are acute and chronic kidney disease treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment of acute kidney disease depends on what is causing it. Treatment may include:

  • Hospital stay

  • IV (intravenous) fluids in large amounts to replace fluid loss

  • Medicines (diuretics) to increase the amount of urine made

  • Close monitoring of important blood salts (electrolytes) such as potassium, sodium, and calcium

  • Medicines to control blood pressure

  • Changes to diet

In some cases, children may develop severe problems with electrolytes. They may have dangerous levels of certain waste products normally eliminated by the kidneys. Children may also develop fluid overload. The child may need dialysis in these cases.

Treatment of chronic kidney disease depends on how well the kidney is still working. Treatment may include:

  • Medicines to help with growth, prevent loss of bone density, treat anemia, or a combination of these

  • Medicines (diuretics) to increase the amount of urine made

  • Changes to diet

  • Dialysis

  • Kidney transplant

Most children with kidney disease see both a pediatrician and a nephrologist. A nephrologist is a healthcare provider with special training to treat kidney problems.

Online Medical Reviewer: Adler, Liora C, MD
Online Medical Reviewer: Hanrahan, John, MD
Date Last Reviewed: 5/1/2017
© 2000-2017 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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