Kidney Diseases in Children

Understanding the Causes and Care for Pediatric Kidney Diseases in Children

Even though kidney diseases are very rare in children, it is very important that we give the utmost care to kids suffering from kidney-related problems.

The child’s kidney function may deteriorate either through acquired or genetic disorders.

Few kids are born with kidney diseases and a few get it over time, diagnosing and treating them as early as possible becomes very important to provide them with fruitful later years of life.

The functionality of kidneys is affected by imbalanced blood pressure, diabetes, and electrolyte imbalances. The filtering process of the kidneys fails and would require assistance through dialysis.

Our expert pediatric nephrologists do a thorough analysis of the condition your kid is facing through advanced diagnosis and provide you with the best pediatric care for your children.

Managing Congenital Kidney Disorders in Kids

Congenital kidney disorders refer to abnormalities or kidney diseases that your kid is born with. Babies develop these disorders even before birth and mostly they are genetic (hereditary - passed down from parents/bloodline).

Congenital diseases of the kidneys include:

Nephrotic Syndrome

Pediatric nephrotic syndrome occurs when the glomeruli (kidney filters) are damaged. This can be observed with various symptoms like

• Protein leakage in urine, you can notice foamy urine. This is caused because the filters are damaged which hampers the filtration of protein from the blood vessels.
• Hypoalbuminemia - Serum albumin also known as blood albumin levels drop, serum albumin, a protein in the blood works as a shield protecting the fluid leakage from blood to other tissues of the body.
• Hyperlipidemia - blood lipids, your cholesterol (good or bad), and triglycerides levels in the body take care of transferring energy to all parts of the body. These lipid levels will elevate which affects the flow of energy and can cause chronic diseases.
• Swelling of body parts like the face, legs, and hands can also indicate the presence of nephrotic syndrome in children

Nephrotic syndrome cannot be cured completely but with early detection and proper treatment the symptoms can be managed and further damage can be prevented.

Hydronephrosis

Hydronephrosis is a condition where one or both kidneys get swollen due to the retention of water inside them.

This mostly affects babies in the womb and little kids due to the narrowing of the urinary tract, urine infections, and a narrowed ureter which affects the urine flow.

Hydronephrosis can show a few symptoms like

• Painful urination
• Urinary tract infections
• Nausea
• Recurrent Fevers
• Urgent and frequent urination

Hydronephrosis can be treated and recovery is possible. The diagnosis can be done through blood tests, urine tests, and ultrasound during pregnancy.

If your kid is facing symptoms of hydronephrosis, consult the best nephrologist as early detection can pave the way to better results with expert treatment.

Polycystic Kidney disease (PKD)

A kidney condition where cysts are grown inside the kidneys, these cysts are abnormal sacs containing fluids that hamper kidney functions and can lead to kidney failure in the long run.

There are two types of Polycystic kidney disease

1. Autosomal dominant polycystic kidney disease (ADPKD)

This is the most common type of PKD, where 90% of the cases are observed in the age group 30-40, but there are chances this can be developed in children as well.

2.  Autosomal recessive polycystic kidney disease (ARPKD)

This is a rare type of PKD, where the symptoms are seen in a kid at a very early age, sometimes even in the womb.

If your kid is suffering from PKD, they might experience the following symptoms:

• Bloody urination
• Hypertension (High blood pressure)
• Pain in the abdomen area
• Frequent urination
• Urinary tract infection
• Kidney stones
• Pale skin
• Joint paint
• Ridges across fingernails and toenails
• Fatigue
• Weak skin which can be bruised easily

Most often PKD cannot be treated with any treatment, but with advancements in nephrology the symptoms can be controlled like

• Managing Hypertension through medications which would also help in preventing kidney damage
• Medication for pain due to kidney stones and infection helps in reducing the pain.
• Certain Antibiotics help in treating urinary tract infection
• Treatments are provided to treat blood in urine and to reduce the progression of the cysts
• If the kidneys are already damaged, dialysis may be offered

Consult with our specialist pediatric nephrologists for expert care for your child.

Vesicoureteral reflux (VUR)

Vesicoureteral reflux is a condition in which the urine flows in the reverse direction from the bladder back to the tracks and sometimes ends up in the kidneys. The reverse flow might be in one or both the ureters.

This condition occurs because the valves which control the reverse flow are damaged. This affects the normal flow, where the urine flows down from the kidneys through the ureters and fills up the bladder

This condition is common in children, where 1 in 3 kids suffering from UTI is affected by vesicoureteral reflux. Being most commonly found in children below the age of 2, it is highly seen in girls. But this could affect teenagers and adults as well.

The condition is common to be found in children whose parents, and siblings are also affected by reflux.

Even though reflux does not portray many symptoms we can watch out for the following:

• Urinary tract infection
• Bladder infection
• Kidney infection
• Urine retention
• Painful urination

Vesicoureteral reflux can be managed and cured with the right treatment and early detection. If left untreated it might cause kidney scarring (Renal scars), leaving permanent scars on the kidneys.

This condition occurs in 5 grades ranging from 1 - 5, 1 indicating mild reflux and 5 being a serious condition.

There are two types of VUR

Primary Vesicoureteral Reflux

The most common type of VUR is primary VUR, where the child is born with an abnormal ureter. The valve between the ureter and bladder does not close properly paving the way for urine to flow back to the kidney, if only one ureter is damaged it is called unilateral VUR and when both the ureters are damaged its called bilateral VUR

In most cases, the primary VUR gets better as the child grows up.

Secondary Vesicoureteral Reflux

Secondary VUR occurs due to various reasons including narrowing of ureters, and blockage of the urethra, as the blockage affects urine passage, some amount of urine stores up in the bladder and runs back to the tracts.

It might be caused because of neurological problems when the nerves connected to the bladder cannot help in contracting and releasing the bladder.

Secondary VUR is often seen affecting both the ureters and both kidneys.

Sometimes secondary VUR is diagnosed even when the baby is in the womb. When the fetus has urine blockage.

After carefully observing the symptoms, the age of the baby, and the family history of VUR our pediatric nephrologists suggest a few tests and scans to diagnose VUR like urinary tract imaging, abdominal ultrasound, and voiding cystourethrogram.

After knowing the exact reason and cause of VUR, our expert pediatric nephrologist plans to provide holistic treatment to treat VUR including medication to control symptoms, antibiotics for infections, surgery to clear blockages, and reconstructive surgeries to treat abnormal bladder and ureter.

Agenesis

Renal agenesis is a condition where one or both kidneys fail to develop properly in the fetal age.

There are two types of renal agenesis, unilateral and bilateral renal agenesis. Unilateral renal agenesis is a condition in which one kidney fails to grow and develop.

Children with unilateral renal genesis can comfortably lead a healthy and normal life with one functional kidney and little to no complications.

Children struggling with Renal Agenesis might show symptoms of:

• Hypertension
• Proteinuria (foamy urination)
• Hematuria (bloody urination)
• Swelling of face, hands, and legs
• Glomerulonephritis
• Developmental defects in the genital tract, inner ear, head and back

If your kid is diagnosed with unilateral renal agenesis, they would require regular checkups and tests to keep kidney function in check. But if your child is suffering from bilateral renal agenesis they would require dialysis or transplant to ensure proper kidney function.

Our expert pediatric nephrologists provide the best treatment tailored to your child’s specific condition and requirements.

Horseshoe kidney

During the fetal development stage, the baby’s kidneys do not have proper growth, they join in the lower end to become one big kidney instead of two kidneys. This forms a horseshoe shape[U], which is why this congenital kidney disease is called horseshoe kidney.

Even though horseshoe kidneys do not affect life expectancy or harm your kid’s day-to-day life, there are quite a few chances of developing kidney cancer.

There is no medical proof of why horseshoe kidney is formed, there might be an association between Down syndrome and Turner syndrome.  Babies who form horseshoe kidneys can have the following symptoms:

• Vomiting
• Pain during urination
• Nausea
• Recurrent urinary tract infections
• Fever
• Abdomen pain
• Kidney stones
• A lump in the abdomen
• Pain in the hip area

Horseshoe kidneys mostly have complications including

• VUR
• Ureteropelvic Junction Obstruction (UPJ)
• Hydronephrosis
• PKD

Usually, horseshoe kidneys are not removed or operated on, there is no cure for this disease. If there are no symptoms there would be no need to treat it, but if the symptoms are mild or severe the treatments will be effective to control them.

Multi-cystic dysplastic kidney

An asymptomatic congenital disease, where the ureter does not grow well in the fetal age, the process of growth is hampered, a kidney consisting of many irregular cysts are formed filled with fluids.

As the connection to the bladder is not formed, the kidney cannot perform well or produce urine.

If this happens to only one kidney, the child will be able to live a normal life with one kidney taking over functions of both the kidneys. Unfortunately if both kidneys are affected by multicystic dysplastic kidney it is fatal.

As the disease is asymptomatic, you would not see any kinds of symptoms, but it can be observed and examined with an ultrasound when the baby is in the womb. When the mother goes to regular checkups over a period of 5 weeks gestation, the physician can observe abnormal cyst formation filled with fluids and will guide you accordingly.

Uretero Pelvic Junction Obstruction

A condition when there is a blockage in the area where the ureter connects with the kidney pelvis. This is a common obstruction observed during pregnancy. The condition worsens when there is urine buildup in the kidneys due to narrowing of ureters.

This condition is commonly diagnosed in a prenatal ultra sound. But at times, the diagnosis cannot be made until the baby is born.

Symptoms of UPJ include:

• Back and flank pain
• Blood in Urine
• Abnormal mass growth in the abdomen
• Vomiting
• Poor physical growth
• Kidney infection
• Urinary tract infection

Most cases of UPJs resolve on their own as the child grows, but when the symptoms worsen and are not cured surgical intervention would be necessary, medications to control the symptoms also would be recommended. Usually a pyeloplasty surgery is performed to prevent kidney injuries and correct the blockage.

This surgery can be performed traditionally, through a laparoscopy and even as a robotic surgery.

Minimally invasive surgeries for UPJs have shown 97% success rates.

Best Treatment for Pediatric Nephrotic Syndrome in Bangalore

If you find your child facing any symptoms of nephrotic syndrome like foamy urination, bloody urination, uneasiness while urinating, swelling in any or all parts including face, hands and legs, consult with our expert pediatric nephrologists at NU Hospitals.

Through state of the art facilities, advanced equipment, and experienced specialists we provide the holistic and best care tailored to your little ones’ conditions.

Our expert doctors will provide you with the best possible solution, medication, and treatment options while educating on the diagnosis, impact and how to improve your child’s overall health.

Symptoms and Solutions for Chronic Kidney Disease in Kids

When kidneys are damaged and are not able to function well or filter the wastes for a very long period, where both kidneys are in the same condition is the condition called chronic kidney disease.

CKD usually turns into complete kidney failure in the long run which would require renal replacement therapy, either dialysis or transplant.

• Swelling of face, hands and feet
• Loss of appetite
• Frequent urination (while sleeping)
• Dry and itchy skin
• Nausea and vomiting

CKD cannot be cured completely but you don't have to lose hope as there are options which would help your kid to lead a healthy life. Your physician might offer you two options: Dialysis or Kidney transplant based on the condition of the child. After careful evaluation of the internal and external factors affecting the child’s condition and environment, the best option would be offered.

Understanding signs and treatment options of Pediatric Kidney Infections

When the baby’s kidneys are affected by bacterial or viral infection in the kidneys, they cause pain and discomfort in the bowel area and abdomen region. This usually happens when the kid develops a urinary tract infection which would spread up to the kidneys. This condition is called pyelonephritis.

The symptoms are similar to other kidney disease and may include:

• Poor feeding
• poor appetite
• vomiting
• Diarrhea
• Lower back pain in older children
• Nausea

Firstly, the kid must be treated for UTI and fever, additional close care is required for babies who are under 2 years of age.

Our pediatricians would suggest a urine test to confirm infection along with the above mentioned symptoms.

Your kid would be given oral medication of antibiotics to control and cure the infections, however if the condition has not changed and if your kid is an infant the antibiotics may be given in an IV form (intravenous) in the hospital and would be under observation.

Keeping your kid hydrated becomes a crucial part of the treatment, ensure your kid takes enough amount of water as advised by the doctor and this can be treated within a week or two.

Make sure to follow up and get the subsequent tests done to ensure there is no residue of bacteria or virus present inside the body and continue the course of medication as prescribed.

Recognising the Uncommon and Rare Childhood Kidney Diseases

Did you know 72% of the rare diseases are genetically acquired and 3/4th of them occur in childhood?

Uncommon childhood kidney diseases are very difficult to recognise as they can be asymptomatic or can portray symptoms of other diseases.

Some of the rare childhood kidney diseases include:

• Atypical hemolytic uremic syndrome (aHUS)
• Alport syndrome
• Mediated kidney disease
• Complement 3 glomerulopathy (C3G)
• Cystinosis
• Fabry disease
• Granulomatosis with polyangiitis (GPA)
• Hemolytic uremic syndrome (HUS)
• Henoch-Schonlein purpura (HSP)
• IgA nephropathy
• Lupus nephritis
• Primary hyperoxaluria

NU Hospitals is equipped with state of the art facilities, advanced equipment and trained experts with decades of experience to cater to your child’s individual needs. Providing top notch health care services since 25+ years, we are committed to provide your child with the best treatment for pediatric nephrology issues