Kidney disease is very rare in children. Children are often asymptomatic in the early stages of kidney disease. The prevalence of kidney disease in children varies depending on factors such as age, underlying health conditions, congenital anomalies and infections.
What is Kidney Disease?
Kidney disease is a medical condition that occurs when the kidneys are damaged and cannot filter the blood properly. This damage can lead to the accumulation of waste and fluid in the body, which can cause additional health problems. Acute kidney injury (AKI) is a sudden decline in kidney function that usually lasts for a brief period. Although AKI is a temporary condition, it can have long-lasting effects even after treatment for the underlying problem. If left untreated, AKI can be life-threatening. Chronic kidney disease (CKD) develops slowly over a long period, typically months to years. CKD may eventually lead to kidney failure, which requires a kidney transplant or dialysis to maintain better health for a more extended period. When kidney failure is treated with a kidney transplant or dialysis, it is referred to as end-stage kidney disease (ESKD)
What Are The Complications of Kidney Disease in Children?
Complications of kidney disease in children may include:
- Cardiovascular disease, or heart disease
- Electrolyte imbalances in the blood, especially potassium
- Growth problems, especially shorter-than-average height
- Metabolic acidosis
- Mineral and bone disorder
- Cognitive issues
- Urinary incontinence
Symptoms of Kidney Disease in Children?
Children in the early stages of kidney disease may not have any noticeable symptoms. As the condition progresses, symptoms may include swelling in the hands, feet, legs, or face (oedema), changes in urine output (either an increase or decrease), foamy urine due to excess protein (proteinuria), or pink or cola-coloured urine caused by the presence of blood (haematuria). Additionally, children with kidney disease may experience decreased appetite, fatigue, fever, high blood pressure, itchy skin, nausea or vomiting, shortness of breath, trouble concentrating, weakness, weight loss, and stunted growth. The symptoms can vary from child to child, depending on the underlying cause of the kidney disease.
What Causes Kidney Disease in Children?
Kidney disease in children can stem from various factors, including congenital anomalies, infections, and underlying health conditions. Discover more on what causes kidney disease in children below:
Birth defects that prevent the normal development of the urinary tract are one of the most likely causes of kidney disease. A birth defect occurs when a part of a baby's body does not develop properly while the baby is still in the uterus. Examples of birth defects that may lead to kidney disease include renal agenesis or kidney agenesis (when a baby is born without one or both kidneys), kidney dysplasia (when parts of one or both kidneys fail to develop normally), and renal hypoplasia (when one or both kidneys are smaller and have fewer nephrons than normal).
This typically occurs when a parent passes a gene mutation to a child. Certain kidney diseases can be hereditary, which means that a parent passes down a gene mutation to their child. Some common hereditary kidney diseases that affect children include polycystic kidney disease, which causes the growth of cysts in the kidneys and eventually damages them, as well as Alport syndrome, which affects the outer lining of the cells in the kidneys.
Kidney disease can also occur after an infection in another part of the body. Hemolytic uremic syndrome is a condition that can happen when red blood cells are destroyed and block the kidneys' filtering system, often caused by Escherichia coli (E. coli) bacteria. Post-streptococcal or post-infectious glomerulonephritis is another disease that can develop when the immune system produces antibodies that can deposit in the kidneys and cause damage. This disease may occur after an episode of strep throat or a skin infection.
Nephrotic syndrome is another type of kidney disease that can develop when tiny filters in the kidney, called glomeruli, become damaged and allow protein to leak from the blood into the urine. In children older than age 12, diseases that affect the glomeruli are the most common cause of chronic kidney disease (CKD), accounting for approximately 45% of cases. Some common causes of nephrotic syndrome in children include minimal change disease, focal segmental glomerulosclerosis, and membranoproliferative glomerulonephritis, which are disorders that damage the glomeruli.
Systemic diseases, which affect many organ systems or the entire body, can also cause kidney diseases. Lupus nephritis is an example of a systemic disease that often affects the kidneys. Lupus nephritis is a kidney disorder caused by an autoimmune disease called systemic lupus erythematosus, or lupus.
Trauma such as burns, dehydration, bleeding, injury, or surgery can cause very low blood pressure, which decreases blood flow to the kidneys, leading to acute kidney injury or failure.
Urine Blockage or Reflux
Urine blockage or reflux can also cause kidney damage. If a blockage develops between the kidneys and the urethra, urine can flow back up into the kidneys. Reflux occurs when the valve between the bladder and the ureter does not close all the way, allowing urine to flow backwards from the bladder to the kidneys. If the urine in the bladder becomes infected, infected urine can travel backwards to the kidneys and cause a kidney infection
How do Healthcare Professionals Diagnose Kidney Disease in Children?
Healthcare professionals rely on a child's medical and family history, as well as a physical examination, to diagnose kidney disease. To confirm the diagnosis, they may recommend one or more of the following tests:
- Urine Tests: These help determine how well the kidneys are filtering blood and whether there are any proteins in the urine.
- Blood Tests: These are used to test the glomerular filtration rate and identify any underlying diseases.
- Imaging Tests: These help visualise the size, shape, and any abnormalities of the kidneys.
- Kidney Biopsy: This is a procedure that can help determine kidney damage and identify the cause of kidney disease.
- Genetic Tests: These help identify specific gene mutations. If your healthcare professional suspects that your child has kidney disease, they may refer you to a paediatric nephrologist, who specialises in treating kidney disease in children