Kidney problems are very common in children. Unlike heart, lung and liver diseases, kidney diseases do not cause any signs until most of the functionality is lost and diagnosis is often made late. Therefore, it is very important for every parent to notice any signs or symptoms of kidney disease in their children.
Signs and symptoms of kidney diseases in children
- Painful urination
- Red/brown coloured urine
- Poor stream of urine
- Passing urine less than 4 times a day
- Passing urine more than 12 times a day
- Edema around the eyes
- Disturbed growth or bone deformities
- Excessive thirst
Different types of kidney diseases in children
- Urinary tract malformation, present since birth
- Kidney stones
- Nephrotic syndrome
- Urinary tract infection
- Acute renal failure
- Chronic renal disease which can lead to renal disease
Diagnosis of kidney diseases in children
In order to diagnose kidney diseases in children, a paediatric nephrologist may assess the severity of kidney diseases and accordingly order certain investigations.
- Urine test gives a lot of information such as the presence of proteins, RBCs, WBCs and crystals.
- Urine Culture is done to eradicate the possibility of a urinary tract infection.
- BUN and creatinine levels increase when the kidney is not functioning properly. Other blood tests such as electrolytes, haemoglobin, blood gases are sometimes required.
- Sonography is a useful test to detect kidney diseases. It gives extensive information such as the size of kidneys, congenital malformation (single kidney/polycystic kidney), hydronephrosis (swelling of the kidney), any blocks in the urinary tract, kidney stones, and kidney tumours.
- Tests such as renal scans and kidney biopsy are rarely required.
Treatment of kidney diseases in children
Treatment of kidney diseases differs from person to person. Antibiotics are given for 10 – 14 days in urinary tract infections. Prednisolone (steroid) is used in nephrotic syndrome. Some malformations may require surgical correction.
In adults, when the kidney fails, dialysis is done and sometimes kidney transplantation is the only cure. Similar treatments are also available for children. Dialysis is of 2 types: Peritoneal dialysis (preferred in children) and haemodialysis. Due to kidney failure, harmful substances such as urea, creatinine, potassium, phosphorus and excess water accumulate in the body. These are removed by dialysis. Dialysis does not cure the underlying kidney disease. Here’s everything you need to know about kidney dialysis.
Kidney transplantation for children is available in India for End Stage Renal Disease. In kidney transplantation, normal kidney of a donor is fitted in place of the diseased kidney of the patient surgically. The donor can be alive or brain dead. For transplantation, appropriate permissions need to be taken and legal procedures to be followed.
Which specialist to consult
Kidney doctors for children are called paediatric nephrologists who can be consulted for urinary complaints or kidney diseases. If kidney problem persists for more than 3 months, blood creatinine level is high or kidneys are abnormal on sonography, then a paediatric nephrologist should be consulted.