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Kidney diseases in Children-
In the context of children, the term “kidney disease” refers to any disorder that interferes with the kidneys’ ability to perform their typical functions. The kidneys are vital organs because they remove waste products from the blood and regulate the levels of electrolytes and water in the body.
Genetic problems, congenital disabilities, infections, autoimmune diseases, and secondary kidney injury from conditions like diabetes and hypertension are just some causes of kidney disease in children.
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Causes of Kidney Disease in Children-
Kidney disease is caused by different factors in children than in adults. The leading causes of children kidney disease include:
- Congenital kidney defects
- Genetic diseases
- Infection in Kidneys
- Nephrotic Syndrome
Congenital Kidney Defects-
With kidney disease, congenital disabilities are physical issues your child has had with their kidneys since birth. The complications affect your baby during pregnancy.
- Some of the most typical forms of congenital renal disease are:
- One kidney in place of two (renal agenesis or solitary kidney)
- Two kidneys, however, one does not function properly (renal hypodysplasia)
- A kidney that is located in an abnormal location, such as below, above, or on the opposite side of the body compared to its usual site (ectopic kidney)
- Abnormalities of the bladder or ureter (obstructed urine flow or “reflux” of urine from the bladder to the kidneys).
The majority of children with kidney birth abnormality will not have significant health issues and will live entire, healthy lives.
Genetic Diseases That Causes Kidney Disease In Children
A genetic disease is transmitted through genes from one or both parents to the offspring. Genes contain DNA and instruct cells on how to function. There is no prevention for hereditary diseases. Some medications can aid in the treatment and management of some genetic diseases.
The following genetic disorders are the most common causes of kidney disease:
- Alport syndrome
Alport syndrome is a rare genetic disorder caused by mutations (changes) in three genes that control the development of specific body parts in children. This causes abnormal growth in your child’s kidneys, hearing, and eyes.
Kidney disease is a consistent symptom of Alport syndrome, with potential hearing loss and visual impairments. The symptoms might begin while your child is relatively young. Fortunately, medications can keep your child’s kidneys healthy and functioning for extended periods.
- Polycystic kidney disease, either autosomal recessive polycystic kidney disease (ARPKD) or autosomal dominant polycystic kidney disease (ADPKD)
One kind of polycystic kidney disease is autosomal recessive polycystic kidney disease (ARPKD) (PKD). As a form of PKD, ARPKD is relatively uncommon. It leads to cyst formation in the kidneys and liver of your child. Cysts are just fluid-filled sacs. Your child’s kidneys will grow considerably more than they should due to the harm caused by the cysts.
Ultrasounds can sometimes detect health problems in infants even before they are born. Babies are particularly vulnerable because of the kidney failure it might induce. ARPKD symptoms are treated medically, typically with medication.
- Nephropathic cystinosis
The most prevalent kind of cystinosis is nephropathic. Cystinosis is a rare genetic disorder in which cystine builds up in your child’s cells. Cystine is a protein-building block. Too much cystine can hurt their organs, including their kidneys and eyes.
A child may start to show signs when they are young. Cystinosis is treated with medications, including those that inhibit cystine accumulation. Without treatment, it might result in renal failure.
Kidney infections in Children-
An infection occurs when bacteria or a virus enters your child’s body and causes disease. Many illnesses are effectively treated with antibiotics and do not result in lasting damage. However, conditions can occasionally cause an inflammatory reaction that damages the kidneys, resulting in:
- Glomerulonephritis
Glomerulonephritis damages the microscopic kidney filters that purify your child’s blood (glomeruli). It may also be referred to as a glomerular disease. Damaged glomeruli prevent your child’s kidneys from removing waste and excess fluid as they should. Your child may develop glomerulonephritis unexpectedly or gradually over time.
- Hemolytic uremic syndrome (HUS)
Hemolytic uremic syndrome (HUS) is a rare condition that develops in children when damaged red blood cells clog the filters in their kidneys. It can damage or even kill the kidneys.
- Interstitial nephritis
Interstitial nephritis is a condition that produces inflammation (swelling) in the tubules of the kidneys, which are responsible for filtering waste products. Because of this inflammation, your kidneys will be less efficient in purifying your blood and producing urine.
There are two different types of interstitial nephritis:
- Acute interstitial nephritis is a condition that only lasts for a short period. This particular form of interstitial nephritis is the most typical one.
- Chronic interstitial nephritis is characterized by a disease course that is longer than weeks, months, or years.
Nephrotic Syndrome-
Nephrotic syndrome is a collection of symptoms indicating that your child’s kidneys are malfunctioning. Among the symptoms are:
- The urine protein content is too high.
- Insufficient protein in their blood
- Too much cholesterol or fat in their blood
- Swelling in their hands, face, ankles, and even their legs and feet
Complications Seen In Children Facing Kidney Diseases
Kidney diseases restrict a child’s kidneys from performing their normal function of filtering waste out of the body as healthy kidneys do. Toxins and waste products can accumulate in the blood, which might lead to the following difficulties.
- Delay in Growth
- Developmental Delay
- Anemia
- Bone Disease
- Other Related Complications
Delay in Growth-
Kidney disease prevents a child’s kidneys from removing waste from the body as efficiently as healthy kidneys. These issues can impede body and brain growth and development. Children with kidney dysfunction develop and grow more slowly than their peers. Children with kidney disease reach puberty two years later than their healthy counterparts. Addressing their health concerns is the most effective method for enhancing a child’s growth with a renal illness. A physician may also provide growth supplements or growth hormones to assist the youngster in attaining adult height.
Developmental Delay-
Kidney disease and its associated complications can affect the developmental pattern of a child’s brain. Children facing kidney disease may face a developmental delay.
- Difficulty In Concentration
- Learning Difficulty
- Inability to recall things
- Having a more difficult time acquiring verbal skills
- The process of learning to walk becomes more difficult.
- Having a lower academic performance
- Limited visual and spatial perception
Anemia–
Anemia is a common consequence of renal disease in both children and adults. It occurs when the body cannot produce sufficient red blood cells. Anemia can cause a child to feel weary, dizzy, or have difficulty concentrating.
Bone Disease-
Kidneys serve a crucial part in maintaining healthy bones. Children with kidney disease frequently have bone problems, such as bone disease or weak, brittle bones. A doctor may recommend specific meals, medications, or growth hormones to avoid bone disease.
Other Related Problems-
When compared to children who are healthy, children who have the renal disease may also have:
- Disordered Behavior
- Emotional Disturbances
- Negative feelings towards oneself
- Damage to the nervous system
- Sleep disturbances
- Inability to maintain bowel and bladder control
Available Treatment For Children Facing Kidney Diseases
Kidney failure in its later stages is hard to treat unless diagnosed early. A structured plan may be established, boosting the chances that the child will recover from their condition and limiting the progression of kidney damage. Available treatments may include:
- Dialysis-
Dialysis is a procedure used to filter blood when the kidneys cannot do so. It aids the kidneys in filtering out the blood of unwanted toxins and fluids. It takes on some of the duties your healthy kidneys usually would handle. A healthy regulated kidney will constantly be filtering out excess fluid and waste. Dialysis is just 10-15% as efficient as a healthy kidney. It’s a crucial method for treating renal failure in children.
Two methods of dialysis are Hemodialysis and Peritoneal Dialysis (PD).
| Â | Hemodialysis | Peritoneal Dialysis |
| What is it? | Several times every week, your blood is filtered by a machine at a dialysis center. | A cleansing solution is inserted into the stomach and then retrieved multiple times a day and overnight. |
| Any specific diet plans? | Because waste and fluid buildup between treatments, you must rigorously control potassium, sodium, phosphorus, protein, and fluids. | Phosphorus, potassium, sodium, and protein might be limited in your diet. PD treatments are more frequent than in-center hemodialysis, so this diet plan may be less rigorous. This gives you more food and drink options. |
| How do I actually receive treatment? | AV fistula in arm; AV graft in arm, thighs, or groin location; catheter in chest. | By catheter in belly. |
| Best option for whom? |
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What are the risks of dialysis?
Dialysis is a necessary and potentially lifesaving treatment for children with renal failure. The vast majority of children with renal failure receive this treatment. But still, it has adverse effects, impacts your child and family’s lifestyle, and carries risks.
- A catheter, a thin, long tube inserted for certain forms of dialysis, might become contaminated. The health care team for your children will teach you how to clean the catheter and the skin around it (the outlet) to reduce the likelihood of infection and will keep an eye out for any signs of illness.
- Some children experience increased fatigue during dialysis. Depending on the type of dialysis, additional side effects and dangers may be present.
- Dialysis is a problematic treatment that will significantly impact your child and family. If your child undergoes home dialysis, you will be instructed on how to operate the machine. If your child receives dialysis at a hospital, he must travel to the dialysis unit at least thrice a week.
How can you assist your child?
Having your child undergo dialysis treatment can be a trying and stressful time for the entire family. The healthcare team for your children will provide more information and assistance during treatment. You and your child will learn more about how to assist with dialysis as time passes. Your child’s healthcare team is there to provide guidance. They can help with dialysis-related vacations, education preparation, and government benefits. Talking to other families with children on dialysis can also be a tremendous source of support.
2. Kidney transplant
In children with chronic renal disease, stage 5, the most effective treatment for renal failure is a kidney transplant. Nonetheless, the children must be ready for a kidney transplant and have a suitable donor. Children can enjoy entire and healthy lives after a successful kidney transplant while taking medications to maintain their new organs. The timing of a kidney transplant depends upon several variables, including the availability of qualified donors.
Children and babies younger than two may be required to wait until they are old enough to receive a kidney transplant.
When a kidney is transplanted, what happens?
- Your child will be hospitalized for a week or two following kidney transplant surgery. The healthcare team will carefully monitor the surgery to ensure no complications, such as bleeding or infection.
- You and your child will be instructed on the drugs necessary to keep the body from rejecting the replacement kidney. They are referred to as immunosuppressants. Taking them can increase your child’s risk of infection, particularly in the days following surgery. Thus, keep your children away from the sick.Â
- Everyone at home should frequently and thoroughly wash their hands. You visit the doctor often during the first months after surgery to ensure the new kidney is working well.
- If your child has a fever, diarrhea, less energy, or changes in the amount of urine, contact the transplant office immediately. These may be signs that your child’s body is not accepting the new kidney or that the child has an infection.
How parents can care after kidney transplant?
Chronic illness can be difficult for your child. Dialysis, surgery and immunosuppressive therapy can increase stress. Talk to your child about these changes and how to incorporate them into your routine.Â
- Make sure you have time to do fun things with family and friends.Â
- For teenagers, immunosuppressive therapy can be a challenge.Â
- These medications can cause: acne or acne that worsens, weight gain, mood changes sleeping problems, and hair loss; many of these side effects get better with time.
But they are a big reason why teenagers can stop taking medications after a transplant. This can be dangerous and even lead to the rejection of the new kidney. Do not change or stop medications without talking to your care team. In some cases, medications can be altered to reduce side effects and still be effective and safe. Discuss the necessity of taking medications as prescribed with your child and assisting them.Â
How can you help your children after the transplant?
The safest action is to keep them engaged and discuss their issues with them.
 If your child needs more support, visit a therapist or counsellor.Â
Find a support group. They are an excellent way for children and youth to relieve stress and connect with others with similar challenges. Online resources include Transplant Living. Get support for yourself too. Discussing your emotions with others who know what you are going through can be beneficial. Ask your transplant care team if they know of family support groups.
