Understanding Kidney Disease in Children

Your kidneys are one of the most important organs in your body. They perform multiple vital tasks throughout the day. They remove wastes and excess water from your blood. They also regulate mineral (phosphorus, sodium and potassium) levels in the body and produce an important hormone called Erythropoietin that helps in red blood cell production and prevents anemia.

Kidney failure in children can be caused by birth defects, hereditary diseases, nephrotic syndrome(a disorder that causes over excretion of protein in your urine) and systemic diseases (diseases like hypertension - that affect the whole body). Trauma including injury, severe dehydration or burns, urinary blockage and infection can also lead to kidney disease in children.

Types of Kidney Diseases in Children

Kidney disease in children can range from treatable disorders with long term consequences to life-threatening conditions. There are two types of kidney diseases. 

1. Acute kidney disease develops unexpectedly and suddenly. It may or may not be treatable.
2. Chronic Kidney Disease (CKD) is a long term ailment wherein damaged kidneys can no longer filter blood normally. This disease worsens over the years leading to kidney failure, which can be treated by kidney transplant or dialysis.

Symptoms of Kidney Disease in Children

Your child might exhibit the below symptoms that could be an indicator of kidney disease.

• Edema or swelling in areas like the feet, ankles and face.
• Burning sensation when your child tries to urinate.
• Blood in the urine.
• A sudden increase in urine quantity.
• Urinary incontinence.
• High blood pressure and recurring fever.
  
  

Helping Your Child Cope With Kidney Disease

Children who suffer from kidney failure, especially CKD, can routinely experience issues like loss of bladder control (urinary incontinence) that can make a dent in their self-image. They can also find school going a challenge and will need their school administrators, teachers and classmates to be educated and made aware of the effects of CKD.

These children may have to miss school several times in the academic year due to medical appointments and dialysis. Parents or guardians would have to work around and outside school hours to schedule the child’s medical appointments.

Children who have had a kidney transplant may experience side-effects of the medications they take, like weight gain, acne or facial hair. Therefore, encouraging your child to mingle with other kids, make friends and participate in sports activities, summer camp and recreational activities may help boost your child’s morale, self-confidence and self-esteem.

It is important for the parent and child to be educated about the course of treatment including multiple medications, specific diets and other instructions to control the disease. Your child’s dietitian can help monitor eating habits on a daily basis.

Kidney Disease and Nutrition for Your Child

Children with CKD who are undergoing dialysis lose essential nutrients from their body. However, an overdose of specific nutrients may also put a load on the kidneys. The health care provider, therefore, needs to educate the parent and child about the nutrients that need replenishing on a daily basis.

1. Proteins – Children with CKD need to increase their protein intake as they grow because protein is lost through dialysis. However, high-quality protein intake needs to be limited as an excess of it can burden the kidneys causing a decline in its functionality.
2. Sodium – The dietitian or health care team would limit or add sodium and salt in the diet depending upon your child’s age and other factors.
3. Potassium – Too little or excess of potassium may lead to heart and muscle problems. Your child will have to eat low-potassium fruits and vegetables such as apples, strawberries, pineapple, cabbage, boiled cauliflower, and uncooked broccoli. The number of servings and portion sizes will also matter which would be recommended by your child’s dietitian.
4. Phosphorus – Too much phosphorus can deplete calcium from the bones, making them weaker and more likely to break. It can also cause itchy skin and red eyes. As CKD progresses in your child, the health care expert will provide a phosphate binder with meals in order to lower the concentration of phosphorus in the blood. Phosphorus is present in high-protein foods.
5. Fluids – Your child’s damaged kidneys may produce either too much or too little urine. This could lead to swelling or dehydration. The health care provider would recommend the right amount of fluid intake during every follow-up.

Helping your child to live life with CKD can be challenging, but the journey is easy when you have the right health care providers and family for support.