Pediatric nephrology: Conditions we treat at CHoR

Kidney or renal failure in children can happen when the kidneys lose normal kidney function, causing temporary or permeant damage to the kidneys.

Symptoms of acute or chronic kidney failure can be different and depend largely on the underlying cause. Because they may resemble other conditions or medical problems, it’s important to see a kidney specialist for a diagnosis.

Signs your child may be suffering from acute or chronic kidney failure:

• Hemorrhage
• Abdominal pain
• Bone pain
• Fever
• Rash
• Bloody diarrhea
• Severe vomiting
• No urine output or high urine output
• Recurrent urinary tract infections
• History of recent infection
• Pale skin
• Hearing problems
• Bad breath
• History of taking certain medications
• History of trauma

Kids with chronic kidney disease have damaged kidneys that can’t filter blood the way they should. This happens over a long period of time and causes waste buildup in your body along with other health problems.

In infants and children, it can be caused by birth defects, hereditary diseases or congenital abnormalities. Recurrent urinary tract infections (UTIs) should be treated immediately and further evaluated by a specialist to determine if the UTIs could potentially lead to chronic kidney disease.

In children over the age of 12, glomerulonephritis (inflammation of the kidneys) is the most frequent cause of chronic kidney disease. Other conditions that may damage the kidneys or diseases that affect many organs, like lupus, can also cause kidney failure.

Electrolyte disorders in children are caused by an imbalance of fluids and electrolytes in the body. Most common electrolyte disorders

Most often the cause of this disorder is dehydration and involve a lack of calcium, potassium and sodium. The specialists at CHoR can help effectively identify and treat this disorder.

Glomerulonephritis refers to an inflammation of the tiny filters in your kidneys that remove excess fluid, electrolytes and waste from your bloodstream.

While symptoms of glomerulonephritis can vary depending of if you the acute or chronic form, the most common symptoms your child might experience include:

• Pink or cola-colored urine
• Foamy urine
• Fluid retention with swelling in your child’s face, hands, feet and abdomen

Urine does not normally contain red blood cells, so if they are prevalent in your child’s urine, it is because the filters in the kidney are allowing blood to leak through.

There are two types of hematuria: one is microscopic hematuria, where the blood is only detected in a microscope and the other is gross hematuria where the urine appears red or the color of cola or tea.

Hemolytic uremic syndrome is a kidney condition that happens when red blood cells are destroyed, clogging the kidneys’ natural filtering system. If the kidneys stop doing their job properly, your child could develop acute kidney failure.

Commons symptoms of hemolytic uremic syndrome in children include:

• Vomiting
• Abdominal pain
• Headache, fever and chills
• Bloody diarrhea

It’s important to seek care from a children’s nephrologist to diagnose and begin treating the complications right away.

Hereditary kidney diseases are passed from parent to children through genes. During your visit, we will discuss your family’s medical history and whether there are any pre-dispositions we should be aware of, such as polycystic kidney disease (PKD) or Alport syndrome.

Hypertension is a long-term medical condition that your child may experience. A certain amount of blood pressure is needed to keep the blood flowing in your body, but children with hypertension have an excessive force of blood flow which results in high blood pressure.

While it typically takes more than one measurement to diagnose hypertension, if your child has blood pressure over 120/80, we recommend monitoring and conducting tests as they are at higher risk of developing hypertension.

Kidney malformations can occur when a baby’s kidneys and urinary tract do not develop properly in the womb.

Aplasia: Occurs when an organ or tissue is largely absent or not whole.

Dysplasia: This happens when a developing baby’s flow of urine is severely blocked.

There are other abnormalities that can occur, and our nephrologists are specialists in diagnosing and caring for your child and family.

Kidney stones happen when crystals made from minerals are formed inside the kidney.

Kidney stones can cause pain and blood in your child’s urine. Most kidney stones may pass without causing damage with the assistance of pain medicine and plenty of fluids.

Learn more about kidney stones

Metabolic acidosis happens when there is a buildup of acid in the body due to kidney disease or failure. While not every child will experience the same symptoms, if they are showing the following, you should let your health care provider know so we can help diagnose and treat this accordingly.

• Fast heartbeat
• Vomiting or nausea
• Loss of appetite
• Weakness of the body
• Headache or confusion

If your child has too much protein in their urine, swelling of various body parts and sudden weight gain, they could have nephrotic syndrome, or nephrosis.

Often, the first sign of nephrosis is swelling around the eyes in the morning. You may notice that the swelling lasts all day and moves to their belly, ankles or feet. If your child is also more tired, irritable, pale and lacks appetite, you should consult with our team of nephrologists to effectively diagnose and treat this condition.

This condition causes a blockage in urine flow from the kidneys to the bladder. While normally your child’s urine will flow through the ureter, obstructive uropathy can cause a backwards flow of urine into the kidneys.

It’s important to note this can happen to children of all ages, even to an unborn child in the womb.

While symptoms in each child may vary, common signs of an obstructive uropathy include:

• Blood in the urine
• Frequent urination and feeling as if the bladder isn’t empty
• Pain in your side or back near the kidneys
• Weak or slow urination
• Fever
• Nausea or vomiting
• Swelling of the hands, arms, feet and legs
• Decreased urination

Polycystic kidney diseases (PKD) is a hereditary disorder in which cysts develop in clusters within your kidneys. Overtime this can lead to kidney swelling and failure.

It’s not uncommon for people to go years without knowing they have it, but if your child has a first-degree relative with polycystic disease, we will want to screen for this disorder to detect it early and discuss how to make lifestyle changes to treat it.

Learn more about PKD

If there is protein in your child’s urine, they may have proteinuria. While all children have a small trace of protein in the urine, if they have too much it may mean the kidneys aren’t working right.

You’re not going to be able to see the protein in the urine, so it’s important to look out for swelling in your child’s eyelids, legs and ankles, as well as high blood pressure. A urine sample will be able to help determine if there is a larger than normal amount of protein in their urine.

By consulting with a kid’s nephrologist, we will be able to help determine the best course of action to help diagnose and treat any complications.

Spina bifida happens when the spinal bones don’t close properly when they are formed. Because of this, brain receptors have difficulty passing messages to various parts of the body like your urologic system. Because kidneys are an integral part of the urinary tract system, a kidney evaluation will be done in conjunction with our urology, orthopaedic and neurosurgery teams.

With this multidisciplinary team, we can help manage all aspects of spina bifida to ensure your child is well cared for.

Vasculitis is a condition that happens when your child’s blood vessels are inflamed and swollen.

Vasculitis is classified based on the size of the blood vessel involved (small, medium or large). Symptoms your child will experience largely depend on the size and number of inflamed blood vessels and their location.

Common symptoms of vasculitis in the kidney include:

• Kidney failure
• Decreased amount of urine
• Blood and protein leakage
• Abdominal pain
• Diarrhea or blood in stool

If your child is experiencing any of these symptoms be sure to contact our nephrologists right away.