What Is Pediatric Kidney Disease?

What Is Pediatric Kidney Disease?

‘Pediatric kidney disease’ is a broad-spectrum term that covers a range of conditions affecting the kidneys in children. This article includes a detailed guide on its causes, types, diagnosis, symptoms, and the role of healthcare professionals in treating them. 

Types of Pediatric Kidney Diseases

Various types of pediatric kidney diseases can affect children. Here are some common types: 

1. Congenital Anomalies

• Congenital Hydronephrosis
• Polycystic Kidney Disease (PKD)

2. Glomerular Diseases
3. Inherited Disorders

• Alport Syndrome
• Nephronophthisis

4. Urinary Tract Infections (UTIs)
5. Renal Tubular Disorders
6. Acquired Kidney Diseases

• Acute Glomerulonephritis
• Hemolytic Uremic Syndrome

Pediatric CKD (chronic kidney disease)

Kidney diseases are relatively uncommon in children. Many children may not exhibit noticeable symptoms until the disease has progressed. As a result, it becomes difficult to recognize the true number of affected children. 

Pediatric CKD is one of the most commonly occurring types of kidney disorders in [1] boys over the age of 6 years when compared to girls.

The disease results in long-term kidney damage or kidney dysfunction. While complete recovery is not possible, your healthcare professional can help you and your child to manage it effectively for a healthy lifestyle. 

Pediatric CKD progresses in 5 stages and is dependent on GFR (i.e. glomerular filtration rate).

Pediatric Renal Tumors

Pediatric renal tumours refer to the development of abnormal growths or tumours in the kidneys of children. They are relatively rare but represent a significant proportion of childhood malignancies. 

The most common types of renal tumours in children include—

• Wilms tumour
• Clear cell sarcoma of the kidney
• Renal cell carcinoma 

Wilms tumour (Nephroblastoma):

Wilms tumour is the most common renal tumour in children. It usually affects children between the ages of 2 and 5. Imaging studies like ultrasound, CT scan, and MRI are used to evaluate the tumour and determine its extent.

Treatment typically involves a combination of surgery, chemotherapy, and sometimes radiation therapy. 

Clear Cell Sarcoma Of The Kidney (CCSK):

Clear cell sarcoma of the kidney is a rare malignant tumour that primarily affects young children. Treatment typically involves surgical resection of the tumour, sometimes followed by chemotherapy or radiation therapy depending on the specific case.

Renal Cell Carcinoma (RCC):

RCC is extremely rare in children.

Children with RCC often present with symptoms such as:

• abdominal pain
• hematuria (blood in urine)
• or a palpable mass.

Treatment for pediatric RCC usually involves surgical removal of the tumour, followed by additional therapies if needed.

Imaging studies, such as ultrasound, CT scan, and MRI, help evaluate the tumour and determine its characteristics in all the above 3 cases. 

Pediatric Acute Kidney Injury

Pediatric acute kidney injury (AKI) refers to a sudden and sharp decline in kidney function in children. It is a serious condition that requires prompt recognition and the right actions to be taken at the right time to improve it. 

AKI can result from various causes, including dehydration, sepsis, medication toxicity, urinary tract obstruction, and certain medical procedures. 

Treatment may involve fluid resuscitation , optimizing hemodynamics , addressing the underlying cause, and providing renal support as necessary. 

Acute Renal Failure In Pediatrics

Renal failure refers to the inability of the kidneys to adequately filter waste products and maintain fluid and electrolyte balance. It can be acute or chronic, and it can result from various underlying causes or certain medications. 

Common symptoms may include—

• Decreased Urine Output
• Fluid Retention
• High BP
• Fatigue
• Abnormal Electrolyte Levels 

Common Symptoms Of Kidney Disease In Children 

Most pediatric kidney diseases show little to no symptoms in the early stages and that is why their detection is not possible. However, when the disease gets worse following general symptoms are seen:

• oedema
• a significant increase or decrease in the production of urine. Some children might have the need to urinate more frequently sometimes resulting in wetting the bed.
• proteinuria
• hematuria
• decreased appetite
• feeling tired
• fever
• high blood pressure
• itchy skin
• nausea 
• vomiting
• shortness of breath
• trouble concentrating
• weakness
• weight loss
• stunted growth 

Diagnosis Of Pediatric Kidney Disease

The diagnosis of Children’s kidney diseases like pediatric renal tumours, pediatric acute kidney injury, acute renal failure in pediatrics, etc. is done using two types of methods: 

• Non-invasive Methods
• Invasive Methods

The non-invasive methods include:

1. Physical Exam 
2. Medical History
3. Urinalysis
4. Microalbuminuria
5. Creatinine Clearance 
6. Imaging studies

• Standard X-rays 
• Angiography 

7. Intravenous Urography
8. Ultrasounds
9. CT Scans 
10. Magnetic resonance imagery (MRI)

The invasive methods: 

1. Blood Tests
2. Serum creatinine 
3. Blood Urea Nitrogen 
4. GFR
5. Voiding cystourethrogram (VCUG)
6. Kidney Biopsy 

Treatment Approaches for Pediatric Kidney Disease

In order to treat and manage pediatric kidney diseases with maximum efficiency, it is very important to consider both: a pediatrician & a nephrologist. 

Your healthcare professional might start by prescribing antibiotics (in case of an infection) to treat the underlying cause of the specific type of disease. 

Treatment options depend on the type and severity of the kidney disease. They may include:

 Medications

Doctors may prescribe medications to control blood pressure, reduce inflammation, manage proteinuria (excessive protein in urine), or treat underlying causes such as infections or autoimmune conditions.

 Dietary Modifications

A balanced diet with appropriate restriction of certain nutrients, such as sodium and potassium, may be recommended to manage pediatric kidney disease. 

Dialysis

In cases of advanced kidney failure, dialysis may be necessary to filter waste products and excess fluid from the blood. Pediatric patients may undergo either hemodialysis or peritoneal dialysis, depending on individual circumstances.

Kidney Transplant

When kidney function is severely compromised, a kidney transplant may be considered. Transplantation offers the potential for long-term improvement in kidney function, providing a better quality of life for children with end-stage renal disease.

In addition to these treatments, healthcare professionals will also suggest regular monitoring, follow-up visits, and strict commitment to prescribed medications and lifestyle changes.

They work closely with pediatric nephrologists to develop a detailed care plan that addresses the unique needs of each child. 

Conclusion

All in all, when it comes to keeping your child healthy, the more you delay, the more complicated the disease gets. Therefore, it is essential to call the doctor at the right time regardless of whether your child is an infant or older.