8 Types Of Kidney Disease In Children, Causes And Symptoms

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Kidneys are bean-shaped organs that control water levels and eliminate waste products through urine. Kidney diseases in children can be acute (sudden) or chronic (permanent), and the outcomes may vary accordingly. Genetic kidney diseases are more prevalent in children than adults. Most of these diseases are diagnosed during prenatal testing and require medical or surgical treatment. Other kidney issues, such as urinary tract infections (UTI), may occur later in life (1) (2).

Read on to learn about the types, causes, risk factors, symptoms, and treatment of kidney diseases in children.

How Common Is Kidney Disease In Children? 

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Around one or two in every 100,000 children under the age of 19 can develop kidney failure. African American teenagers are thrice more likely to develop kidney failure than Caucasians of the same age. Moreover, boys are twice as likely to develop kidney disease as girls (3). 

What Are The Types Of Kidney Disease In Children? 

Kidney diseases that develop from birth are (1):

1. Posterior urethral valve obstruction: It is obstruction or narrowing of the urethra. The disease occurs mostly in boys and can be treated with surgery after birth

2. Fetal hydronephrosis: One or both kidneys are enlarged because of the obstruction in the developing urinary tract, or when the urine flows backward from the bladder into the ureters (vesicoureteral reflux). This type of hydronephrosis in babies is diagnosed before birth and may sometimes be treated with surgery. 

3. Polycystic kidney disease: Fluid-filled cysts develop in the kidneys that multiply, leading to kidney failure. Polycystic kidney disease is mostly inherited and can be diagnosed before or after the child is born. The disease requires dietary changes, but it is just supportive measure. In most cases, a kidney transplant or dialysis is needed.

4. Multicystic kidney disease: Large cysts develop in one of the kidneys that have not formed properly. The affected kidney eventually stops working; however, children with this disease can lead a normal life with the other healthy kidney. It can be diagnosed before birth, and surgery is needed only in rare cases.

Quick fact

Multicystic Dysplastic Kidney (MCDK) is a condition where a kidney is abnormally formed in the womb. Though a rare occurrence, it is likely to affect 1 in 4000 births (9).

5. Renal tubular acidosis: The disease occurs when kidneys cannot remove acids from the blood. It can affect a child’s growth and cause kidney stones and bone disease. Immediate treatment is important for prevention of these complications.

6. Wilms Tumor: Wilms Tumor, also known as nephroblastoma, is a rare and treatable kidney cancer. As stated in the National Cancer Institute, for children below 20 years with Wilms tumor, the five-year relative survival rate is 93%. Children with this disease can lead a normal life after treatment. In some cases, the tumor is believed to grow with the fetus in the womb.

7. Glomerulonephritis: Glomerulonephritis is a condition where the kidneys are unable to clean the blood. As a result, children experience swelling in the body or difficulty with urinating. If left untreated, the disease may lead to kidney failure. Dietary changes and medicines are used to treat the condition.

8. Nephrotic syndrome: Nephrotic syndrome occurs because of the damage in the blood vessels of the kidneys. In this condition, kidneys pass excess protein in the urine.
   

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Sometimes, the baby’s urinary tract does not develop properly in the womb, leading to kidney problems. These congenital problems are:

• Duplication of the ureters, in which a kidney has two ureters rather than one. This condition can cause urinary tract infections and can be treated with surgery.

• Horseshoe kidney, in which two kidneys are fused into one arched kidney. It functions normally but needs to be regularly checked by healthcare providers. It might need surgical intervention.

Other problems associated with kidneys 

Sometimes, other health conditions in children might prevent the kidneys from functioning normally. They include:

• Hypertension (high blood pressure)
• Kidney stones
• Nephritis (inflammation of the kidneys caused by infection or autoimmune disease)
• Urinary tract infections (UTIs) (bacteria enter the bladder or kidneys) 

Caution

Frequent urinary tract infections (UTIs) should be treated promptly in children, When left untreated, they might lead to long-term kidney damage or chronic kidney disease (kidney failure) (6).

What Are The Causes And Risk Factors Of Kidney Disease In Children?

Several factors can increase the risk of kidney disease in children.

Acute kidney disease

• Reduced blood flow in kidneys due to surgery, dehydration, blood loss, or shock
• Blockage in the urinary tract
• Medications that cause kidney problems
• Conditions such as cardiac arrest  slow down or block the oxygen and blood flow into the kidneys
• Hemolytic uremic syndrome is caused by E.coli infection, where it leads to kidney failure because of blocked small blood vessels and structures (4)

Chronic kidney disease

• Blockage in the urinary tract for a long period
• Alport syndrome (an inherited disorder that causes deafness, eye problems, and kidney damage).
• Cystinosis (an inherited disorder where amino acid called cystine accumulates in the kidneys).
• Untreated acute kidney disease may also turn chronic if not treated on time.
• Other conditions include untreated diabetes, hypertension, chronic urinary tract infection, and lupus (4).

Apart from these factors, kidney disease in children can also occur from birth defects. These defects occur while the baby is growing in the mother’s womb. The common birth defects are (5):

• Babies born with a single kidney (renal agenesis)
• Babies born with two kidneys, one of which does not function (renal dysplasia)
• Babies born with dislocated kidneys (ectopic kidney)

Most children born with these birth defects do not face any major problems; however, it is important to contact a pediatrician/child nephrologist.

What Are The Symptoms Of Kidney Disease In Children? 

The symptoms of acute and chronic kidney disease may differ from each other.

Some common symptoms of acute kidney disease are (4) (6):

• Fever
• Rash
• Hematuria (blood in urine)
  

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• Chronic nausea and severe vomiting
• Abdominal pain
• No urine or excess urine
• Diarrhea with bleeding
• Pale skin
• Swollen tissues
• Inflamed eyes
• Mass in the stomach 

Some common symptoms of chronic kidney disease are (2) (4) (6):

• Chronic nausea and vomiting
• Bone pain
• Poor appetite
• High blood pressure
• Poor growth
• No urine or excess urine
• Frequent UTIs
• Urinary incontinence
• Pale skin
• Mass in the stomach
• Hearing impairment
• Bad breath
• Swollen tissues
• Irritable behavior
• Change in alertness
• Poor muscle tone
• Weakness and fatigue
• Change in the urine color, indicating blood
• Extra foam formation in urine, indicating protein

What Are The Complications Of Kidney Disease? 

Kidney disease or failure may lead to several complications as follows (4):

• Anemia (low level of red blood cells in the body)
• Heart problems
• Bone disease
• Bone, joint and muscle pain
• Improper mental function, leading to confusion, less concentration, and dementia
• Nerve damage in upper and lower limbs
• Highly prone to infections
• Poor nutrition
• Dry and itchy skin 

How Is Kidney Disease Diagnosed In Children? 

If healthcare providers suspect the child has kidney disease, they will start with a medical history and physical examination. Then, further diagnostic tests are done to confirm the disease (1) (4) (3) (7) :

1. Blood tests: A blood sample is examined to check the kidney function (amount of blood the kidney filters in a minute), blood cell count, and electrolyte levels.

2. Urine test (Urinalysis): This helps detect abnormal functioning of the kidneys. The test indicates inflammation in the urinary tract and detects excess white cells caused due to infection.

3. Renal ultrasound: This is an imaging test that enables doctors to see the shape and size of the kidneys. The test also helps to examine the presence of cysts, stones, or any other growth in the kidneys.
   

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4. Kidney biopsy: In this procedure, a small sample of the kidney tissue is taken with the needle and examined in the lab. It helps to accurately understand the functioning of the kidney and the extent of the damage.

5. Bone scan: This nuclear imaging method helps examine the signs of bone diseases, tumors, or inflammation.

6. Chest X-ray: This test enables doctors to understand the functioning of the lungs and heart.

7. Electrocardiogram: This test enables doctors to understand the heart’s functioning and rule out any chance of heart tissue damage. 

How Is Kidney Disease Treated In Children? 

The treatment of kidney disease in children depends on the cause and severity of the disease.

The treatment for acute kidney disease might include (4):

• Hospital admission
• Intravenous fluid administration to replenish the fluid loss
• Diuretics to increase the amount of urine
• Tracking electrolyte levels in the body
• Medicines to control blood pressure
• Dietary changes

The treatment for chronic kidney disease includes (4):

• Medicines to address bone problems and anemia
• Dietary changes
• Dialysis
• Kidney transplant (removing the damaged kidney and replacing it with a new one)

Did you know?

In 2020, about 700 children (below the age of 18) received a kidney transplant in the United States (10).

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1. Birth defects: Treatment is generally not required for children with kidney disease due to birth defects. Doctors continue to observe the patients over a period and might perform surgery if there is a blockage or damage to the kidney.

2. Hereditary diseases: Children with polycystic kidney disease are given antibiotics to fight urinary tract infections and other complications.

3. Infections: Children with hemolytic uremic syndrome need to maintain their electrolyte and fluid levels. In some cases, they may also need a red blood cell transfusion. Some children need dialysis for a short period, while most children recover after the treatment.

4. Trauma: If children have kidney disease due to trauma, they are first treated for trauma. They may also require dialysis for a short time until the kidney function resumes.

5. Urine blockage: Mostly, the blockage resolves on its own. If the blockage continues, surgery is performed to remove it. 

Dietary Changes During Kidney Treatment

In the course of kidney treatment, diet plays an important role. Some dietary changes your child might need to make in the diet are (4):

• Reduce the protein intake because the kidneys may not efficiently eliminate the excess protein.

• Limit food containing potassium because the excess potassium may accumulate in the blood (hyperkalemia), which can be life-threatening (8).

• Avoid phosphorus-containing foods because extra phosphorus can cause calcium to leave the bones.

• A low-sodium diet helps reduce fluid retention in the body.

Congenital Diseases of the Kidney | Riley Children’s Health (rileychildrens.org)

Infographic: How Does Chronic Kidney Disease (CKD) Or Kidney Failure Affect Children?

Chronic kidney diseases or kidney failure can affect a child’s physical and mental development. Sometimes, loss of bladder control causing accidental urination, restriction in activities, or need for long-term medical treatments can cause emotional trouble in children. Go through the infographic to know the challenges in children with kidney failure or CKD to address them on time.

Illustration: Momjunction Design Team

Illustration: Types Of Kidney Disease In Children Causes And Symptoms

Image: Dall·E/MomJunction Design Team

This video will explore the causes and effects of kidney disease in children. Learn how to recognize the signs and how to help your child manage the condition.

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Dr. Garima Garg SethMD

Dr. Garima Garg Seth is a well-known pediatrician in Gurgaon, having more than 19 years of experience in this field. She has completed her education from topmost organizations in India, including AIIMS, New Delhi; Sir Ganga Ram Hospital, New Delhi; and CMC Vellore.

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Pragya BhargaviMSc, BEd

Pragya Bhargavi has been in the field of content research, writing and editing for over six years. Her passion for academics and science has enabled her to write creative as well as research-based articles. She has completed her Masters in Microbiology from Bangalore University and obtained a Bachelor’s degree in Education (BEd) from Acharya Nagarjuna University, Guntur.

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Dr. Ritika ShahBDS, CLC

Dr. Ritika Shah is a certified lactation counsellor (CLC) from iNational Health Care Academy, Singapore and a dental surgeon with more than seven years of clinical experience across various cities in India. She did her graduation in Dentistry from KM Shah Dental College.

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Dr. Joyani DasM.Pharm, PhD

Dr. Joyani Das did her post-graduation from Birla Institute of Technology, Mesra and PhD in Pharmacology. Previously, she worked as an associate professor, faculty of Pharmacology, for two years. With her research background in preclinical studies and a zeal for scientific writing, she joined MomJunction as a health writer.

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