Kidney disease in children: causes, symptoms and how to treat it

Kidney disease not only affects adults, but can be experienced by children. This is a condition when the kidneys experience damage or decrease in function. As a parent, it is important to know the causes, symptoms, and how to treat a child with kidney disease. The following is a complete explanation of kidney disease in children.

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What is kidney disease in children?

Quoting from the official website of the University of Rochester Medical Center, kidney disease is kidney damage that reduces the function of these organs. This condition can occur in the short term to be permanent.

There are two types of kidney disease, namely:

Acute kidney disease

This type of kidney disease attacks suddenly. In some cases, acute kidney disease can recover more quickly and the kidneys function normally again.

However, it is possible that the condition could become more serious and last a long time.

Chronic kidney disease

Meanwhile, for chronic kidney disease, this is a condition of kidney damage that progresses slowly, usually more than 3 months.

This condition can most likely turn into permanent kidney failure.

What are the symptoms of kidney disease in children?

There are several characteristics of kidney disease in children that need to be watched out for, namely:

• There is swelling (edema) symmetrically on the left and right leg.
• Hematuria, blood in the urine
• Leukosuturia, an increase in the number of leukocytes (white blood cells) in the urine
• Proteinuria, increased protein excretion in the urine
• Oliguria, decreased urine production
• Hypertension
• Growth disorders
• Anemia
• Bone abnormalities
• Hard to breathe
• Recurrent fever

Be sure to consult a doctor for further diagnosis if your child has one or more of the above symptoms.

What causes children to experience kidney disease?

The causes of kidney disease in children are distinguished by type, acute and chronic kidney disease. But in general, this is the cause of kidney disease in children, as reported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK):

• Birth defects
• Hereditary diseases
• Infection
• Nephrotic syndrome
• Systemic diseases (disorders of the body's metabolic system conditions)
• Trauma
• Blockage in the urinary tract

The most common causes of kidney disease in children <5 years are congenital disorders such as polycystic kidney and urinary tract obstruction.

Meanwhile, in children> 5 years, the most common causes are disorders of the absorption of the kidneys (glomerulus), such as nephrotic syndrome and lupus nephritis to congenital abnormalities.

Specifically, the causes of kidney disease can be divided into three, pre-renal, renal, and post-renal, citing the media. briefings : Recognize Kidney Disorders in Children, Ministry of Health of the Republic of Indonesia

Causes of pre-renal kidney disease:

• Dehydration
• Bleeding
• Burns
• Severe infection (sepsis)
• Heart defects

While the causes of renal kidney disease, namely:

• Congenital abnormalities of the kidneys
• Glomerulonephritis
• Abnormalities in the renal blood vessels
• Damage to kidney structures

For causes of post-renal kidney disease:

• Congenital abnormalities of the urinary tract
• Blockage of the urinary tract

Pre-renal causes means that the cause of kidney damage is caused by problems outside the kidneys.

Renal causes mean that it is kidney damage caused by problems in the kidneys themselves. Meanwhile, post-kidney is the cause of kidney damage due to disturbances in the renal tract.

Other chronic conditions can also cause chronic kidney disease in children, such as diabetes or high blood pressure. Both can cause kidney problems.

Risk factors for kidney disease in children

If a parent or family knows the risk factors for a child developing kidney disease, doctors need to regularly screen this group.

The risk factors are:

• Low birth weight (LBW) babies
• History of acute renal impairment
• Hypertension, obesity and diabetes
• History of urinary tract disorders
• There is a known kidney disorder
• There is a family history of kidney disease

If your little one has the above factors, it is necessary to screen regularly.

What complications can a child have with kidney disease have?

Given that the kidneys have so many functions, the damage to kidney function can affect a person's system and metabolism. Complications that can occur include:

• Anemia
• Problems with the heart and blood vessels
• Bone disease
• Pain in the bones, joints and thighs
• Problems with mental function, such as dementia
• Damage to the feet and hands
• Malnutrition
• The skin becomes dry, irritated and itchy

You need to consult a doctor before kidney disease turns into a complication.

How is kidney disease diagnosed in children?

To diagnose a child with kidney problems, there are three stages of examination that need to be done, namely:

• Laboratory (blood, urine, creatinine, electrolyte, lipid profile tests)
• Imaging (USG, MRI CT-Scan)
• Others (kidney biopsy)

It is difficult to distinguish between chronic or acute kidney disease in a child when he comes to the hospital. However, the ultrasound results can show signs.

Quoting from the official website of the Indonesian Pediatrician Association (IDAI), in acute kidney disease, ultrasound showed a slight enlargement of the child's kidneys and the results of blood tests found hemolytic anemia and decreased platelet levels.

Meanwhile, in chronic kidney disease (CKD), a family history of kidney disease is found, ultrasound images show the kidneys are shrunken, asymmetrical, and there are cysts.

How to treat a child with kidney disease?

Children who experience kidney disease will be accompanied by a pediatrician and nephrology, a doctor who specializes in examining your little one's kidneys.

Treatment of children with kidney disease depends on their symptoms, age, type, health condition, and severity.

The treatments carried out are:

• Giving fluids.
• Diuretic medicines to increase the amount of urine.
• Control of salt levels in the blood (electrolytes) such as potassium, sodium and calcium.
• Medicines to control blood pressure.
• Medicines to help bone growth, prevent bone loss, anemia.
• Change the pattern then.

Children also need to reduce or limit the consumption of some ingredients, namely:

• Protein
• Potassium
• Phosphor
• sodium

The content above is very important for children's growth. However, the kidneys cannot get rid of waste that comes from foods high in protein, potassium, phosphorus, and sodium.

Health workers will discuss with parents about protein levels needed by children with kidney disease.

In some cases of kidney disease in children, it can develop into severe problems with electrolytes. Children can also experience excess fluid and need to do dialysis.

Here are some procedures for filtering waste from the body (dialysis) that children with kidney disease need to do.

Peritoneal dialysis

This method uses the lining of the abdominal cavity (peritoneum) to filter the blood. This cavity is a space that holds organs, such as the stomach, intestines, and liver.

In the first process, the surgeon places a thin, flexible tube (catheter) into the child's stomach.

After that, a sterile cleaning fluid (dialysate) is inserted through the catheter into the peritoneal cavity.

The fluid is left in the stomach for some time to absorb waste. When so, this liquid is drained from the stomach, measured, and removed.

This peritoneal dialysis process can be done at home.

Hemodialysis

This process must be done in a hospital or other health service. This method of hemodialysis uses a special method called an arteriovenous (AV) fistula, where the arteries and veins are joined together.

This method is done on the arm of a child who has kidney disease. Then an external intravenous catheter is inserted and the child is connected to a large hemodialysis machine.

Blood is pumped through the tube into the machine to filter out the waste and fluids in the body. The filtered blood flows through another tube and into your little one's body.

Hemodialysis is usually done several times a week. Each session, lasts 4-5 hours.

Prevention of kidney disease in children

To prevent your little one from the risk of kidney disease, parents need to take preventive steps on the factors that cause it. The trick is:

• Get enough fluids for children.
• Prevent dehydration in children, especially when they have diarrhea or vomiting.
• Reduce exposure to infections, including during pregnancy.
• Consultation about genetic issues to prevent inherited kidney disease.
• Early detection of hypertension and diabetes in children /

If the child has kidney disease, take medication and control regularly. Doctors also treat hypertension, anemia, and proteinuria.