Chronic Kidney Disease

Chronic kidney disease happens when your child's kidneys are no longer functioning properly. Healthy kidneys clean the blood by removing excess fluid, minerals and waste from the blood. The kidneys also make hormones that keep the bones strong and the blood healthy.

Conditions that can cause chronic kidney disease include:

Glomerulonephritis
Congenital diseases of the kidney, such as renal dysplasia, blockage of the ureters or urethra and cystic kidney diseases
Hemolytic uremic syndrome
Hereditary kidney diseases such as hereditary nephritis and polycystic kidney disease
Diseases of the immune system such as lupus
Repeated kidney infections (pyelonephritis)

If your child's kidneys fail, many areas of his or her body may be affected:

Harmful waste material builds up in the body.
The blood pressure may rise.
The body may retain excess fluid.
The body may not make enough red blood cells.

The symptoms of chronic kidney disease include:

Decreased appetite
Vomiting
Bone pain
Headache
Stunted growth
Fatigue
High urine output or no urine output
Pale skin
Bad breath
Hearing problems
Tissue swelling
Irritability
Decreased muscle tone
Decrease in mental alertness

Diagnosis of Chronic Kidney Disease

Your child’s nephrologist will use one or more of the following tests to diagnose chronic kidney disease:

Blood tests. A sample of your child’s blood is drawn and tested to determine how much blood the kidneys filter each minute. This is called the estimated glomerular filtration rate (eGFR). Other blood tests may be ran to determine the blood urea nitrogen (BUN), creatinine and electrolytes.
Urine test. A sample of your child’s urine is tested for abnormalities that can point to chronic kidney disease.
Ultrasound. An ultrasound can help the doctor assess the kidneys’ size and structure.
Renal biopsy. A renal biopsy (removing a sample of tissue for testing) can help your child’s doctor pinpoint the cause of the kidney problem.

Treatments

The course of treatment that your child’s nephrologist recommends will depend on the following factors:

Your child’s age, overall health and medical history
Stage of the chronic kidney disease (Stages 0 to 6)

Potential treatments for chronic kidney disease include:

Medical therapy for stages 0 to 5. Your child’s doctor will likely prescribe a combination of medicines to help control the symptoms of chronic kidney disease as well as help slow its progression. Your child may need to take certain types of blood pressure medicines—andio angiotensin-converting-enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs)—to help slow the progression of the condition. Your child may also need to take a water pill (diuretic).
Hemodialysis for stage 6. In this treatment, a machine and filter do the work that your kidneys normally do, removing waste and other materials from the blood. Hemodialysis helps to control blood pressure and helps the body maintain the proper balance of important minerals such as potassium, sodium, calcium and bicarbonate.
Peritoneal dialysis for stage 6. Instead of using a machine outside the body to perform the kidneys’ functions, waste is filtered through the lining of the abdomen which acts as an artificial kidney. After receiving thorough training, you can help your child undergo this type of dialysis at home on your own schedule.
Kidney transplant for stage 6. Once donated, a healthy kidney can keep your child healthy and symptom-free while receiving medication to prevent rejection of the kidney.

Key Points to Remember

The kidneys serve the important function of filtering waste from the blood as well as regulating other functions of the body.
When the kidneys fail, your child needs treatment to help remove waste from the blood.
Treatment options include medical therapy and medicines, hemodialysis, peritoneal dialysis and kidney transplantation.

Support Services & Resources

Visit the trusted websites below to learn more about chronic kidney disease.

Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.

Learn More About Riley Support Services

National Institute of Diabetes and Digestive and Kidney Diseases

Learn more about the challenges associated with chronic kidney disease in children.

National Institute of Diabetes and Digestive and Kidney Diseases

Visit this National Institutes of Health website to learn more about the treatment methods for kidney failure in children.

National Kidney Foundation

Visit this website to learn more about kidney failure, including its causes and treatments.

American Association of Kidney Patients

The American Association of Kidney Patients shares in-depth information about chronic kidney disease on its website.

Chronic Kidney Disease Research

The pediatric nephrologists at Riley at IU Health participate in the national ongoing CKids study, which is funded by the National Institutes of Health (NIH). The focus of this study is to learn more about the factors that contribute to chronic kidney disease in children and the effects of chronic kidney disease in pediatric patients.

Locations

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