Some Causes of Kidney Disease in Children

When parents first hear their child has kidney disease, they may wonder what they could have done to prevent it. These feelings are common. In most cases, however, there is no way anyone could know their child would get kidney disease and usually nothing that could have been done to stop it. Focusing on what can be done now, such as getting proper treatment, following doctor’s advice, working with your child’s healthcare team and learning all you can about the disease are the best ways to help your child after the diagnosis.

Below are details about some of the common causes of kidney disease in children and the popular treatments. Children’s kidney problems typically stem from one of the following:

  • Birth defects and blockages
  • Infections of the urinary tract
  • Diseases of the kidney itself

Less common, sickle cell anemia and lupus can damage a child’s kidneys, as can a serious accident or fall.

Birth defects and blockages

In most cases, children with kidney disease are born with problems in their urinary tract. The urinary tract is made up of the:

  • kidneys—organs that filter blood and produce urine
  • ureters—tubes where urine travels down from the kidneys to the bladder
  • bladder—sac that holds urine until elimination
  • urethra—tube that eliminates urine from the bladder out of the body

Some children are born with a condition that causes the urethra to narrow or become blocked (posterior urethral valve obstruction). This prevents urine from leaving the body. Surgery is usually done to clear the blockage. Long-term treatment may include medication and additional surgery, if necessary.

Another kidney disease, called fetal hydronephrosis, can happen while the child is in the womb, during infancy or in childhood. In this case, there is a narrowing or enlargement of one or both of the kidneys. Surgery may be needed, although, mild cases may clear up without it. If fetal hydronephrosis is diagnosed during pregnancy, the doctor will check the unborn baby often to see if the condition is getting worse. Sometimes, doctors will insert a small tube into the unborn baby’s swollen bladder and drain off urine in order to protect the baby’s health.

Today, ultrasound allows doctors to see a baby’s kidneys while still in the womb. Many kidney problems can be diagnosed using ultrasound including: fetal hydronephrosis, cysts or tumors, abnormal kidney position, the absence of one or both kidneys and more. With this early diagnosis tool, doctors have the opportunity to treat the child as soon as possible.

Urinary Tract Infections (UTI)

An infant or child develops a urinary tract infection (UTI) when bacteria get into the urinary tract. Normally, urine contains no bacteria, but sometimes bacteria from the skin around the genitals and rectum travel into the urinary tract. When only the bladder is involved, the condition is known as cystitis. When the kidneys are involved as well, the UTI is known as pyelonephritis, a more serious infection that can lead to scarring and permanent kidney damage.

Urinary tract infections are usually easy to diagnose in older children and adults. Symptoms include frequent, painful urination and urine that appears cloudy or bloody. If the UTI involves the kidneys, fever and back pain may also occur.

It is more difficult to diagnose a UTI in an infant or toddler. They may exhibit symptoms such as being cranky or weighing less than expected for their age. Sometimes an infant with a UTI will throw up or have loose bowel movements. Youngsters may experience abdominal pain, run low-grade fevers or wet the bed.

To diagnose a UTI, a urine sample is taken to check for the growth of bacteria. If the child is given antibiotics, relief usually begins within 12 to 24 hours of treatment. If the UTI affects the kidneys, intravenous medications may be necessary, requiring the child to be hospitalized.

After treatment, the doctor will collect another urine sample to determine if the medication has gotten rid of the infection. Since UTIs tend to come back again, the doctor may want your child to be tested on a regular basis.

Reflux disorder and UTIs

Reflux is often diagnosed after a child has a UTI. It occurs when urine goes back up from the bladder to the kidney. This is due to a defect of the “valves” between the ureters and the bladder. Reflux can cause an infection to spread to the kidneys. This can be serious and may lead to kidney damage. About 50% of infants and 30% of older children with UTIs will suffer from reflux disorder.

Sometimes, surgery is done to correct reflux disorder, but most children are treated with antibiotics. Children diagnosed with reflux disorder usually recover after treatment. Typically, they do not have relapses. If kidney damage occurs, however, the child may get high blood pressure later in life. If one kidney is damaged, the risk of getting high blood pressure is 10%. If both kidneys have been injured, the risk rises to 20%. Most children with reflux disorders do well and do not experience kidney damage.

Diseases of the kidneys: nephrotic syndrome

Nephrotic syndrome usually occurs in children aged 6 months to 5 years, although, it can occur in people of any age. Boys are two times more likely to suffer from nephrotic syndrome than girls. Nephrotic syndrome occurs when the kidneys are diseased and unable to keep protein from leaking into the urine. It often appears for the first time after a child has had a cold or infection.

The cause of nephrotic syndrome is unknown. Many researchers are working to determine its cause and develop treatments. Today, nephrotic syndrome is typically treated with prednisone, and most children improve with its use. Sometimes doctors prescribe immunosuppressive medications. Whichever medication your doctor chooses, your child will be monitored closely and get periodic blood tests.

After treatment and recovery, a child may have a relapse, especially after coming down with another cold. The child should be carefully monitored at home so steps may be taken to get treatment. Although there is no cure for nephrotic syndrome, most children do well with treatment, and many “outgrow” the disease by the time they reach their teens. Even when a child has frequent episodes, if he responds well to treatment then permanent kidney damage is not likely.

The outlook for children with kidney disease has improved greatly in the last 30 years, in both quality of life and long-term outcomes. Dialysis techniques for children have improved and so has pediatric kidney transplantation. Early diagnosis of kidney disease decreases life-threatening complications, boost healthy development and may delay the disease’s progression.

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Warning signs of kidney disease or UTI

Consult your doctor if your child exhibits any of the following:

  • Unexplained low-grade fever
  • Swelling around the eyes, feet, and ankles
  • Lower back pain
  • High blood pressure
  • Persistent abdominal pain
  • Frequent severe headaches
  • In kids 5 years or older, frequent bedwetting, especially if the problem recurs after the child had stopped bedwetting for some time
  • Unpleasant-smelling urine
  • Urine that is cloudy, bloody or dark brown
  • In newborns and infants, poor eating habits, vomiting, or chronic diarrhea
  • In older children, poor appetite
  • Slow growth or weight gain
  • Weak urinary stream, dribbling or fanning of urine stream
  • In infants, crying during urination
  • In older kids, painful urination
  • Weakness, excessive tiredness or loss of energy
  • Pale skin or “washed out” appearance

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