What is Chronic Kidney Disease?
Chronic kidney disease (CKD) is an umbrella term for several conditions that affect the kidneys, but it generally means permanent, and usually, progressive damage to the kidneys caused by a variety of conditions. The main causes of CKD in children are anatomical/structural abnormalities or inherited conditions, such as polycystic kidney disease. Conditions that cause damage to the kidneys’ filters, the glomeruli, can lead to chronic kidney disease.
Diabetes and high blood pressure are the leading causes of chronic kidney disease in adults, but they can also lead to chronic kidney disease in children. When the kidneys are damaged, they gradually lose their capacity to remove waste products from the blood. Kidney disease also increases the risk of heart and blood vessel disease. These problems may develop slowly, over a long period of time and often without symptoms. CKD may eventually lead to kidney failure and require dialysis or kidney transplantation. Early detection and treatment may prevent CKD from getting worse and prevent some of its complications.
Early kidney disease may not cause any symptoms for a while or the signs could be very subtle, such as mild puffiness around the eyes or foamy urine. Other signs, particularly, as CKD progresses, include:
- swelling of the hands and feet
- nausea and vomiting
- fatigue and loss of appetite
- blood and/or protein in the urine
Complications of untreated chronic kidney disease include high blood pressure, anemia (not enough red blood cells), stunted growth and nerve damage. Hypertension (high blood pressure) can be either a cause of kidney disease or a result of it because as the kidneys are damaged they lose their ability to regulate blood pressure. In children, it is more commonly a complication of the disease not the cause. High blood pressure must be treated with medication and lifestyle changes.
- Urinalaysis measures the amount of protein in the urine, which will give the doctor clues about the extent of the damage.
- Blood tests can show if the level of protein in the blood is abnormally low, which indicates loss of protein through the kidneys.
- Blood tests will show the level of creatinine, a waste material filtered by the kidneys, in the blood. High creatinine indicates loss of filtering capacity.
- Ultrasound and X-rays can reveal any damage to the kidneys and surrounding structures.
- A kidney biopsy may be taken to examine kidney cells under a microscope and determine the cause and extent of damage to the kidneys. It is usually the definitive way to diagnose kidney disease.
Treatment will depend on the underlying cause of the kidney damage. Certain medications can slow or curb the progression of the disease and prevent further damage. Whether high blood pressure is the cause or the result of kidney disease it needs to be monitored aggressive and kept in control by medications.
When to Call for Help
If your child has foamy urine, blood in the urine and/or puffiness around the eyes, swelling of the face, hands or feet, talk to your pediatrician.
At Hopkins Children’s, chronic kidney disease is treated by the division of Nephrology.