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Kidney disease in children

The kidneys play a very critical role in the human body, they function as the filtering units to help maintain the water level in the body and eliminate waste in the form of urine. They are responsible for regulating the blood pressure, producing red blood cells and also maintain adequate calcium and minerals in the body. When these essential organs fail to function effectively, it can cause many health problems. Kidney diseases or problems can affect people of any age, though it is more common in adults, some children can also develop kidney diseases, which can impact their lives.

Kidney disease is temporary or permanent damage to the kidney which can impact the normal functioning of the kidney. There are two types of kidney diseases:

Acute Kidney Diseases: These diseases start suddenly and do not have a definitive cause. In many cases, these can be reversed and kidneys can resume normal function. In some cases, these diseases could leave lasting consequences.

Chronic Kidney Diseases: These are critical kidney diseases which grow over a period of time and are progressive in nature, and can lead to permanent kidney failure.

Causes of Kidney Diseases in Children

 Kidney diseases in children can be caused because of the following factors/conditions:

  • Birth defects
  • Hereditary or genetic diseases
  • Infection
  • Nephrotic syndrome
  • Systematic diseases
  • Trauma
  • Blockage or urine or reflux

In children aged 4 years or less, birth defects and hereditary diseases account for most of the kidney diseases. However, for kids between 5-14 years of age, kidney failure is mostly caused due to hereditary issues, nephrotic syndrome and systematic diseases. For children above 15 and below 19 years of age, diseases affecting the glomeruli are the primary cause.

Birth Defects: Birth defects are problems which develop when the baby is in the mother’s womb. These include renal agenesis (one kidney), renal dysplasia (only one functional kidney) and ectopic kidney (dislocated kidney) diseases, among others. These birth defects usually tend to impact the size, structure, position or functioning of the kidneys.

Hereditary Diseases: These are diseases, which are passed on to the children from a parent through genes.These include polycystic kidney disease(PKD),Alport syndrome, etc.

Infection: An infection in children can lead to major types of kidney problems including:

  • HemolyticUremic Syndrome which occurs when a bacterium lodged in the digestive system produces toxins, which destroy the red blood cells and the lining of the blood vessels, including the glomeruli.Post-streptococcal glomerulonephritis which typically occurs post a step-throat or skin infection and affects the immune system of the child leading to abnormal production of anti-bodies made of protein. These excessive anti-bodies travel around the body and can accumulate in the kidney damage the glomeruli.

Nephrotic Syndrome: These are a group of signs that indicate potential kidney damage. The syndrome includes the following conditions:

  • High level of albumin protein in the urine
  • Higher than usual levels of fat and cholesterol in the blood
  • Swollen hands, feet, ankles or legs
  • Low levels of albumin in the blood

Systematic Disease: These diseases include systemic lupus erythematosus (SLE or lupus) and diabetes, and tend to affect multiple organs or the whole body including the kidneys.

Trauma: Traumas or shocks including burns, bleeding, injury, surgery, etc. can lead to a drop in blood pressure levels which can reduce the blood flow to the kidneys, causing acute kidney failure.

Urine Blockage or Reflux: Urine blockage occurs because of a restriction between the kidneys and urethra. Reflux of urine happens when the urine flows from the bladder up to the kidney because the valve between the bladder and the urethra does not close completely.

Risk Factors for Kidney Diseases in Children

Risk factors which put some children at more risk of kidney problems than others include:

  • Blood loss or surgery
  • Shock or trauma
  • Medications that affect kidneys
  • Health condition impacting the blood and oxygen flow to the kidneys
  • Long-term blockage in the urinary tract
  • Untreated diabetes
  • High blood pressure
  • Family history

Symptoms of Kidney Diseases in Children

The symptoms for kidney disease vary per condition and the type of disease such as acute or chronic kidney problems.

Acute kidney disease symptoms include:

  • Bleeding
  • Fever
  • Rash
  • Diarrhoea
  • Consistent and unexplainable vomiting
  • Stomach pain
  • Excessive urine or absence of urine
  • Pale skin
  • Swollen tissues
  • Swollen eyes
  • Stomach mass

Symptoms of chronic kidney diseases in children:

  • Lack of appetite
  • Vomiting
  • Pain in the bones
  • Headache
  • Stunted growth
  • Malaise
  • Lack of or excessive production of urine
  • Urinary tract infection (mostly consequently)
  • Pale skin
  • Bad breath
  • Hearing issues
  • Swollen tissues
  • Irritability
  • Poor muscle tone
  • Change in mental being and alertness

These symptoms do not necessarily confirm a kidney problem in children, they could also indicate a similar health condition; hence, it is important to seek medical consultation and get a proper diagnosis.

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