Kidney Disease in Children 

Kidney disease affects around 37 million adults in the United States, and is considered one of the most common diseases adults in the US face. Kidney disease is not as common in children as it is in adults, but there are still children affected by, and diagnosed with, kidney disease every year.

Because of the “silent” nature of kidney disease, researchers aren’t sure exactly how many children in the US are affected by kidney disease, but we are learning what to look for and how to spot it.

Symptoms

One of the main ways to prevent irreversible kidney damage and kidney failure is to diagnose early. The problem with that, is symptoms don’t often become disruptive until the late stages of kidney disease when stopping the progression and fixing the damage is difficult. To try to bridge the gap, understanding what the signs of lowered kidney function are can help to identify any issues as early as possible. 

Common symptoms:

• Swelling in the hands, feet, legs and face
• Change in urine output (either an increase or decrease)
• Decreased appetite
• Fatigue
• Fever
• High blood pressure
• Stunted growth

Many of these symptoms can also be caused by other conditions, so if you suspect kidney disease, contact your child's doctor to discuss their symptoms and possible testing options.

Risk factors

There are several risk factors that increase a child's chances of developing kidney disease. Understanding if your child is at an increased risk of kidney disease can help you know if you should be paying closer attention to any of the above mentioned symptoms.

• Birth Defects - Birth defects and inherited family diseases are the most common causes of kidney disease in children. Polycystic kidney disease (PKD) is the most commonly inherited form of kidney disease in children.
• Abnormalities in the urinary tract - Change in the frequency or appearance of urine as well as repeated urinary tract infections are some of the more common manifestations of abnormalities in the urinary tract.

Diagnosis

Kidney disease is diagnosed the same in children and adults. If your child's doctor is questioning a potential kidney disease diagnosis, they will likely run a few tests:

• Urine test - A urine test will let the doctor check for protein in the urine.
• Blood test - A blood test will allow the doctor to check both creatinine levels, which helps them assess kidney function, as well their red blood cell count as low count can be associated with kidney disease.
• Biopsy - The biopsy will allow your child's doctor to see the extent of the damage and get a better idea of the cause of the damage.
• Ultrasound - The images allow the doctor to see what the kidneys look like and see what damage may be present already. It can help the doctor in determining the cause of damage as well. 

To learn more about what these tests look for and how they are administered, you can read here. Tests can be scary and feel intimidating for both the parent and the child. But, understanding what is going on in their body, and why, is crucial in helping your child’s doctor make a diagnosis and pick the correct course of treatment.

Treatment

The goal of most treatments for chronic kidney disease in children is to do three main things:

• Treat the underlying conditions causing kidney disease
• Treat symptoms
• Slow the progression of disease

Treatments will look different child to child as the symptoms experienced and underlying conditions have the possibility to be highly varied. Your child's doctor will work with a pediatric nephrologist (as well as any other necessary specialists related to your child's symptoms) to make sure they get the care and treatment they need. 

Daily Life

A common concern for parents of children with kidney disease is the impact kidney disease will have on their child's ability to live their life and still have a fun and active childhood. Children who begin receiving treatment before they reach the late stages of kidney disease have a very good chance at having a normal childhood. 

While parents will want to monitor their child to ensure they are handling physical activity well, most doctors give a green light for children to participate in sports and play as normal. While the risk of kidney injury is possible, it has been found to be statistically very low in most activities children participate in, including contact sports like football. The most common cause of injury to the kidney due to impact is car accidents, so doctors typically feel confident clearing play and activity for children with kidney disease. 

In the late stages of kidney disease, children may need a kidney transplant. Later stages also come with more disruptive symptoms and the possible need for dialysis while a transplant match is found. These children will likely experience more changes to their daily life and activity levels. The doctors and specialists on your child's healthcare team will work together to make sure your child receives the best care and gets feeling better as quickly as possible.