Yes, children can develop kidney disease. Pediatric kidney disease involves damage that impairs the kidneys’ ability to filter waste from the blood and maintain fluid and electrolyte balance. The causes and progression often differ significantly from adults. While adult kidney failure is frequently linked to long-standing diabetes or hypertension, childhood kidney disease is more commonly rooted in developmental or genetic issues.
Kidney Diseases Present at Birth or Due to Genetics
The leading causes of chronic kidney disease (CKD) in children are conditions present at birth or inherited genetically. Congenital Anomalies of the Kidney and Urinary Tract (CAKUT) are the most common cause of CKD, often leading to end-stage renal disease (ESRD). These anomalies involve structural problems that occur as the urinary system develops in the womb. Defects include renal agenesis, where one or both kidneys fail to form, or kidney dysplasia, where internal structures do not develop normally.
Genetic conditions also contribute to pediatric kidney cases. Autosomal recessive polycystic kidney disease (PKD) causes fluid-filled cysts to grow, progressively damaging kidney tissue. Alport Syndrome is an inherited condition affecting the collagen in the glomeruli, the kidney’s filtering units. This damage leads to blood and protein leaking into the urine, often accompanied by hearing loss and eye abnormalities.
Conditions That Develop Over Time
A child’s kidneys can also be damaged by conditions acquired later in life. Glomerulonephritis is a common acquired cause involving inflammation of the glomeruli, the kidney’s blood-filtering structures. This inflammation often occurs after a systemic infection, such as post-streptococcal glomerulonephritis following an untreated strep throat infection.
Hemolytic Uremic Syndrome (HUS) is another acute condition, often triggered by a specific strain of E. coli bacteria. HUS destroys red blood cells, which clog the kidney’s filtering system and can result in sudden, acute kidney failure. Systemic diseases also target the kidneys, notably Systemic Lupus Erythematosus (SLE), or lupus. Up to 80% of children with lupus may develop Lupus Nephritis, where the immune system attacks the kidney tissue. Type 1 Diabetes, while less common in childhood, can also damage the kidney’s delicate filters over many years.
Subtle Indicators in Children
Early signs of kidney disease are often subtle and non-specific, easily mistaken for common childhood ailments. Poor growth or a failure to thrive is a telling indicator, as damaged kidneys struggle to maintain the balance of nutrients and hormones required for normal development. Persistent, unexplained fatigue and lethargy are also common, resulting from the buildup of toxins the kidneys cannot clear.
Changes in urination patterns are a sign of trouble. These changes include passing urine much more frequently or too little urine, or a sudden reappearance of nighttime bedwetting. Other physical signs include:
- Foamy urine, indicating abnormal protein leakage.
- Dark or cola-colored urine, suggesting the presence of blood.
- Unexplained swelling (edema), often appearing as puffiness around the eyes, face, hands, or feet.
- Childhood hypertension (high blood pressure), which is a direct consequence of kidney dysfunction and can manifest as frequent headaches.
Treatment Paths and Prognosis
Diagnosis begins with a pediatric nephrologist utilizing a combination of tests. These include blood work to measure waste products like creatinine and urine tests to check for protein and blood. Imaging studies, such as ultrasounds, provide a view of the kidney’s structure to identify congenital anomalies or blockages. A kidney biopsy may be performed to determine the exact nature and extent of the damage.
Management strategies are tailored to the underlying cause and severity. Initial treatment often involves dietary modifications, such as managing protein, salt, and phosphorus intake, along with medications to control blood pressure and reduce protein loss. Children with CKD may also need supplements to manage anemia and maintain bone health, or growth hormone injections to support development. If the disease progresses to ESRD, the child requires kidney replacement therapy, including dialysis and transplantation. Transplantation is the preferred long-term treatment for children, offering an improved quality of life and survival rate.