Kidney Disease in Children

Kidneys act as the body’s filtration system, removing waste and extra water. They also regulate red blood cell production, blood pressure and electrolytes in the body. Kidney disease in children can affect some or all of these functions in your child.

Remarkable Care for Kids

• Specialized care for kids with kidney disease: The pediatric nephrology program at Rush University Children’s Hospital provides compassionate, personalized care to kids with kidney disease. The program includes a pediatric hypertension center for kids with high blood pressure, and provides comprehensive care for children, newborn through 18 years of age with chronic kidney disease. Care for children with prenatal kidney disease begins with consultation during pregnancy.
• Nutritional support: Your child’s care team will include a dietitian who will work with and your child to create a diet and nutrition plan that can help address the nutritional challenges associated with kidney disease in children. 
• Prenatal care for babies with kidney disease: If a prenatal ultrasound finds that your unborn baby has a birth defect that affects the kidneys, specialists in the Fetal and Neonatal Medicine Program will map out a treatment plan tailored for you and your baby during pregnancy and after your baby is born.
• Caring for the whole child: Child life specialists at Rush University Children’s Hospital will help your child cope with the emotional, physical and social challenges associated with kidney disease.

What is kidney disease in children?

There are two main types of kidney disease:

• Acute kidney disease develops suddenly. It can go away completely once the cause is treated, or it may have lasting effects on kidney function.
• Chronic kidney disease cannot be cured, and it gets worse over time. Treatment and diet can slow its progression, but eventually can lead to kidney failure and the need for dialysis. Dialysis is chronic treatment until the patient receives a kidney transplant.

Kidney disease causes

Kidney disease in young children is usually caused by the following:

• A birth defect, or congenital problem, can affect the size, structure or position of one or both of your child’s kidneys. This can increase a child’s risk of kidney disease. A urinary tract abnormality can also disturb kidney function. Most of these problems are diagnosed before a child is born with prenatal testing. Your child may need regular monitoring, medication or surgery.
• A hereditary disease, or genetic disorder, is passed from parent to child. Polycystic kidney disease is one example. It causes cysts that prevent the kidneys from functioning properly. Another example is Alport syndrome, which leads to scarring of the kidneys. Your child may need long-term medical care to slow the disease from progressing and to treat complications.
• Though less common, other causes of kidney disease in children can be infections, traumas, autoimmune diseases or certain cancers, such as Wilms tumor.

Kidney disease symptoms

Symptoms vary depending on the cause of disease. Contact your pediatrician if your child has any of the following symptoms:

• Swelling of the eyes, face, feet or ankles
• Burning or pain during urination
• Difficulty in controlling urination (in older children who use the toilet)
• Nighttime bedwetting (in children who don’t usually have this issue)
• Blood in urine
• High blood pressure

Care for kidney disease in children at Rush

Diagnosis

Contact your pediatrician if your child has any signs of kidney disease. Your pediatrician will perform a physical exam, which may include the following:

• Taking your child’s blood pressure, which the kidneys help to regulate
• Measuring your child’s growth (chronic kidney disease slows growth)

Your child’s pediatrician may refer you to a pediatric nephrologist who specializes in kidney diseases in children. Your child’s care team may order the following tests to diagnose your child’s problem:

• Urine tests to determine if there are blood cells or protein in the urine
• Blood tests to show how well the kidneys are filtering waste and balancing electrolytes
• Imaging studies, such as a renal ultrasound, to see abnormalities, tumors or kidney stones
• A biopsy to examine a small amount of cells from your child’s kidney under a microscope

Treatment for kidney disease in children

Your child’s treatment will depend on the cause of disease and how much it has progressed. Your child’s care team may need to address the underlying cause of kidney disease, as well as complications that result.

Medications

Your child’s care may include the following:

• Lowering blood pressure with medication, which can slow the progression of kidney disease
• Treating anemia with the hormone erythropoietin to help your child’s body produce more red blood cells
• Stimulating growth with dietary supplements or growth hormone injections
• Suppressing the immune system with corticosteroids or other medications

Nutritional support

A special diet can slow kidney damage and maximize growth and energy if your child has chronic kidney disease. A dietitian at Rush can work with you, your child and your family to create a diet that meets your child’s needs and lifestyle. This diet will address the following nutritional elements:

• Sodium – your child may need to limit sodium, depending on age and type of disease
• Potassium – too much or too little can cause heart and muscle problems
• Phosphorus – high levels of phosphorus can remove calcium from bones and weaken them
• Protein – your child needs protein to grow, but too much protein can burden the kidneys
• Fluids – controlling fluids can limit swelling and dehydration