Diagnosing kidney disorders in children

Illustration of colorful kidneysThe kidneys play a critical role in the body. As the body’s filtering system, they help control fluid levels and eliminate wastes through urine. They also help regulate blood pressure, red blood cell production and the levels of calcium and minerals.

“Sometimes the kidneys don’t develop properly and, as a result, don’t function as they should, or lead to frequent urinary tract infection and sometimes a lifelong disease,” says Samhar Al-Akash, MD, pediatric nephrologist at Driscoll Children’s Hospital. In young children, these problems are often congenital, or present from birth.

Many of these problems can be diagnosed before a baby is born through routine prenatal testing and treated with medication and/or surgery while the child is still young. Other problems may appear later, with symptoms such as urinary tract infections (UTIs), growth problems or high blood pressure (hypertension). In some cases, the problems may require surgical treatment.

How does kidney disease affect children?

Kidney disease can affect children in various ways, ranging from treatable disorders without long-term effects to life-threatening conditions. Acute kidney disease develops suddenly due to injury to the kidney by drugs, infection, conditions causing very low blood pressure or other causes of inflammation. Acute kidney injury usually lasts a short time and can be serious with long-lasting consequences, or may go away completely once the underlying cause has been treated. Chronic kidney disease (CKD) does not go away with treatment and may get worse over time. “When CKD continues to worsen, it eventually leads to kidney failure, described as end-stage kidney disease or ESRD. The ultimate treatment for ESRD is kidney transplantation,” says Dr. Al-Akash. While awaiting a kidney to be transplanted, blood-filtering treatment called dialysis is often needed. In many cases, if a living kidney donor such as a parent or adult sibling is available, dialysis may be avoided altogether.

Children with CKD or kidney failure face many challenges, which can include:

  • Poor growth
  • Delayed development of language skills
  • Delayed development of motor skills
  • Negative self-image
  • Relationship problems
  • Behavioral problems
  • Learning problems
  • Trouble concentrating
  • Frequent hospitalizations
  • Frequent surgeries and procedures

Kidney failure, also called renal failure, occurs when the kidneys slow down or stop properly filtering wastes from the body, which can cause buildup of waste products and toxic substances in the blood. Kidney failure can be acute (sudden) or chronic (happening over time and usually long lasting or permanent).

  • Acute kidney injury (sometimes called acute kidney failure) may be due to bacterial infection of the blood, injury, shock, heart failure, poisoning or drug overdose and primary inflammation of the kidneys due to disorders of the immune system. Treatment includes correcting the problem that led to the kidney injury and, in some cases, dialysis for a short period of time while in the hospital.
  • Chronic kidney failure often 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 such as spina bifida or small underdeveloped kidneys, scarring of the kidneys due to reflux of infected urine to the kidneys or obstruction of the urinary tract, various forms of kidney inflammation (glomerulonephritis) or chronic severe high blood pressure,” Dr. Al-Akash says. 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 and to correct abnormalities resulting from loss of kidney function such as anemia and growth failure. At some point, a kidney transplant may be needed.

Symptoms of kidney problems

The signs and symptoms of urinary tract or kidney problems vary and include:

  • Fever
  • Swelling around the eyes, face, feet and ankles
  • Burning or pain during urination
  • Significant increase in the frequency of urination
  • Difficulty in controlling urination in kids who are mature enough to use the toilet
  • Recurrence of nighttime bedwetting (in kids who have been dry for several months)
  • Blood in the urine
  • High blood pressure
  • Delayed growth

Driscoll NephrologistsWe can help

If a kidney condition is suspected, your primary care physician will refer you to a pediatric nephrologist, a doctor who specializes in treating kidney diseases. The pediatric nephrologists at Driscoll Children’s Hospital have a long tradition of providing care to children from all over South Texas with clinics serving communities in Corpus Christi, Victoria, Laredo, Brownsville and McAllen.

We’re committed to bringing our expertise and high-quality care to the children of South Texas. We take pride in giving our patients and families the individualized attention they deserve.

Partnering with primary care physicians, as well as other specialists, we’re able to optimize patient care and perform necessary tests and procedures in an efficient and timely manner. In addition to our clinic practices, we provide in-patient consultation services to other hospital services and are available on-call 24 hours a day, seven days a week.

For more information about kidney disorders, please call the Kidney Center at Driscoll Children’s Hospital at (361) 694-5022.