Chronic kidney disease (CKD) is a condition in which the kidneys are damaged and are not able to filter blood as well as they should. This condition can occur in people of all age groups, including children. The most common causes for its occurrence in infants and children is due to birth defects such as posterior urethral valves and other urinary tract abnormalities as well as certain inherited disorders such as polycystic kidney disease. Other reasons for renal failure in children include focal segmental glomerulosclerosis (FSGS), IgA nephropathy and systemic lupus erythematosus (SLE).
Symptoms of CKD in children
Chronic kidney disease usually does not show any symptoms in the early stages. However, with the worsening of this condition, following symptoms may become evident in children:
- Swelling or puffiness around eyes, feet, and ankles
- Frequent urination and bedwetting in children over 5 years
- Poor or stunted growth
- Loss of appetite
- Chronic nausea
- Frequent and severe headaches due to high blood pressure
- Anemia and pale appearance (pallor) due to decreased red blood cell production
Effect of CKD on a child’s life
CKD can affect the day-to-day activities of your child and affect their daily routine. A child with CKD may struggle with:
- Learning and focusing
- Developing physical and communication abilities
- Mental health issues such as depression and anxiety
- Negative self-image or low self-esteem
- Relationship and behavioral issues
- Participating in school and extracurricular activities
CKD may sometimes lead to kidney failure in children, if it developed at an early age. Such children may experience more severe developmental, emotional, and social challenges. With proper treatment and care, many of these problems can be overcome.
Ways to help your child deal with CKD
1. Normalize their experience
When your child is diagnosed with CKD, it is important to make him feel comfortable about it by normalizing his experience. To begin with, as parents, you can explain about the condition in a way that he/she understands. Discuss with your child and let him/her take responsibility for his or her treatment in a manner that is appropriate for age. This will equip your child to take ownership of their health and learn how to take care of themselves in the future. Above all, it is your prerogative as parents to treat your child with CKD at par with other siblings in the family.
2. Make treatment a fun thing
If there is some aspect of the treatment plan that is difficult to follow, try implementing it in a fun way. For instance, innovating with recipes that are safe for the child. To keep the child well-hydrated, you could arrange water drinking competitions that may attract the child. Awards and incentives could be given if the child follows the management plan. Try and gamify their experience!
3. Promote a positive self-image
Sometimes, a child with CKD may feel isolated and alienated, resulting in feelings of low self-esteem. Encourage your child to be involved in normal activities. Helping them recognize their strengths is a great move to increasing their self-confidence. Participating in social events where there are kids with other chronic illnesses can also help to normalize your child’s experience.
4. Encourage mindfulness techniques
Children and adolescents with CKD are often found to have big feelings about their condition. While some may be upset with the limitations that the disease brings, others may be in pain or angry about their situation. In order to help them overcome these feelings, encourage them to practice mindfulness into their daily routine. Some relaxation and mindfulness techniques include deep breathing, yoga, reading books, taking a walk, and journaling.
5. Incorporate dietary modifications
Children suffering from CKD often need dietary modifications. As the kidneys are unable to remove excess water, salt, or potassium from the body, their intake may need to be restricted, depending upon the child’s blood parameters. Dairy products are rich in phosphorus so their consumption may need to be restricted in certain children. Also, the fluid intake for your child needs to be monitored, especially if the body is unable to produce enough urine. Care should be taken to limit the intake of sodium for those children with CKD who have a high blood pressure. Please contact your renal nutritionist for advice on the best diet for your child.
6. Include daily exercises
As the kidneys are unable to work efficiently in CKD, it is important to stress the importance of engaging in exercises and other physical activities. The excess of fluid and toxins will flush out of your child’s body in the form of sweat during exercise. Walking and strength training is beneficial to a child with CKD as these forms of exercise make the bones stronger and stimulate the muscles and nerves. This will help ease “restless leg syndrome” and other nerve-related problems that are so often associated with chronic kidney disease.
7. Forming peer groups
Children and the parents of children with CKD should be encouraged to interact with each other, so as to improve their understanding of the problem , associated challenges, and how to overcome them. Key messages like water and salt restriction and being regular with medications and follow up, options for dialysis and kidney transplantation could be emphasized using plays and other fun activities.
Being a parent, it is your responsibility to encourage your child to overcome his/her fears related to CKD. The role you play will encourage and motivate your child to overcome the feelings of insecurity he/she might have developed. Following the above-mentioned steps will help in making your child’s life easier and better. Be a mentor to your child and lead the way!
Seeking expert advice on kidney health for your child? Visit NU Hospitals in Bangalore, India, which is a reputed institution offering the latest and best in kidney care. The specialists and doctors here are empathetic and work day in and out to relieve kidney-related diseases. The state-of-the-art medical facilities and various treatment options available here will help your child get on the road to recovery soon!
- Chronic Kidney Disease. Nemours KidsHealth. https://kidshealth.org/en/parents/chronic-kidney-disease.html. Accessed on 27 September 2023.
- Chronic Kidney Disease (CKD) in Children. American Academy of Pediatrics. https://www.healthychildren.org/English/health-issues/conditions/genitourinary-tract/Pages/Chronic-Kidney-Disease-in-Children.aspx. Accessed on 27 September 2023.
- 5 Ways to Support Children and Adolescents with Kidney Disease. National Kidney Foundation. https://www.kidney.org/newsletter/5-ways-to-support-children-and-adolescents-kidney-disease. Accessed on 27 September 2023.
- Helping Your Child Adapt to Life with Chronic Kidney Disease. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/children/helping-child-adapt-life-chronic-kidney-disease. Accessed on 27 September 2023.
Author: Dr. Nitin Nayak