Chronic kidney failure involves a deterioration of kidney function over time. In kids and teens, it can result from acute kidney failure that fails to improve, birth defects, chronic kidney diseases, or chronic severe high blood pressure. If diagnosed early, chronic kidney failure can be treated. The goal of treatment usually is to slow the decline of kidney function with medication, blood pressure control, and diet.
The most common kidney diseases in children are present at birth. This narrowing or obstruction of the urethra affects only boys. It can be diagnosed before the baby is born or just after and is treated with surgery. Fetal hydronephrosis is usually diagnosed before the child is born and treatment varies widely. This is a condition in which many fluid-filled cysts develop in both kidneys. The cysts can multiply so much and grow so large that they lead to kidney failure. Most forms of PKD are inherited.
Doctors can diagnose it before or after the child is born. PKD can lead to UTIs, kidney stones, and high blood pressure. This is when large cysts develop in a kidney that hasn’t developed properly, eventually causing it to stop working. While PKD always affects both kidneys, MKD usually affects just one kidney. Fortunately, the unaffected kidney takes over and most people with MKD will have normal kidney function. MKD usually is diagnosed by prenatal ultrasound before birth. Doctors manage it by monitoring blood pressure and screening for UTIs when needed.
Very rarely, surgical removal of the kidney might be necessary. This is when the kidneys do not properly control the amount of acid in the body. It can cause kidney stones and affect a child’s growth, but usually can be treated with medications. This type of childhood cancer involves the kidney, and usually is diagnosed within the first 2 years of life. This is an inflammation or infection of the glomeruli, which are parts of the nephrons that contain tiny blood vessels. Some cases can be treated with medication, while others require dialysis or a kidney transplant. This is when the body loses large amounts of protein through the urine, usually because of a change in the nephrons.
Most cases are diagnosed after a child is a year old. Swelling of the face, abdomen, and extremities are among the main symptoms, and are often relieved with medication. As a baby develops in the womb, part of the urinary tract can grow to an abnormal size or in an abnormal shape or position. This can lead to urinary tract infections over time and can be treated with medication or, in some cases, with surgery. An uncomplicated horseshoe kidney does not need medical or surgical treatment, but it does need to be checked regularly by doctors. Sometimes a child can have other health problems that affect how well the kidneys function.
Kidney stones that are large enough to block the kidney or ureter can cause severe abdominal pain. But most stones usually pass through the urinary tract on their own. In some cases, they need to be removed surgically, or treated with medication or modifications to the diet. Sometimes the first symptoms are pain and blood in the urine. Kidney stones are more common in adults than in kids. This is any inflammation of the kidney. The first symptoms of nephritis usually are high levels of protein and blood in the urine.
Antibiotic treatment should begin as soon as possible so the infection doesn’t spread to the kidneys, where it can cause irreversible damage. In babies, UTIs tend to be more common in boys than girls, perhaps because boys are more affected by congenital kidney problems that increase their risk of infection. Later in life, girls are more likely to get UTIs because of their shorter urethras. Among teens, girls are more likely to develop UTIs than boys, mostly due to the shorter urethra or sexual activity with a full bladder. Urinalysis can also detect an of excess white blood cells, which is most commonly associated with bladder and kidney infections. Certain blood tests tell doctors how well the kidneys are filtering waste products and balancing the bloodstream’s chemical makeup. Two other important diagnostic tools doctors use are blood pressure and growth measurements. Along with the heart, the kidneys are crucial to determining blood pressure. High blood pressure in a child is an important sign that the kidneys need to be evaluated. Accurate growth measurements can provide a clue to diagnosing some kidney diseases because kids with chronic kidney disease often have growth problems. A biopsy is a procedure in which a small piece of the kidney tissue is removed with a needle. Performed while a child is under anesthesia, it’s a simple procedure that can help make an accurate diagnosis of the kidney problem in about 9 out of 10 cases. The most commonly used imaging study, an ultrasound is painless and requires no X-ray exposure or special preparation. It can rule out or diagnose obstructions, developmental abnormalities, tumors, and stones in the kidneys and urinary tract. It can show if the kidneys have developed properly or if the flow of urine is blocked by a stone or a developmental abnormality.