Pediatric Kidney Disease

Kidney disease often goes undetected in the general population, but children and adolescents are at an even greater risk due to the nature of the causes of the diseases and the ambiguity of the symptoms. In adults, 90% of cases are related to glomerular-based renal disease caused by diabetes, hypertension and glomerulonephritis, which cues physicians to suspect kidney disease. In children, 70% of CKD is associated with tubulointerstitial disease and lack the obvious symptoms such as hematuria (red blood cells in the urine), hypertension (high blood pressure) or edema (swelling). Adding to this difficulty, children might not be aware of some of the changes that are impacting their body and will not always let their parents know of potential issues.

A potential indicator of pediatric kidney disease is family history of kidney disease. A genetic-related disease is much more common in children than in adults. Decreased amniotic fluid in a pregnant woman is a common symptom that the baby may have polycystic kidney disease. If there is family history of kidney disease, it is important to let the pediatrician/family doctor know about the genetic conditions.

Common Symptoms for Children

Swelling (even mild) of the hands and feet and/or puffiness around the eyes caused by excess fluid build-up, to the point where the child’s ability to move around normally is compromised
After initial swelling, socks or a belt can leave an indentation in the skin that will persist
Lack of or decrease in appetite (in children with ESRD it is especially important to keep their appetite up because transplant eligibility is based partially on growth)
Decreased or increased frequency of urination
Children who can normally use the toilet without assistance may suddenly begin to wet the bed at night

Long-lasting changes in the color of the urine such as unusually dark or red, which can indicate blood, and changes in appearance of urine such as extra foam that can indicate protein
Headaches resulting from high blood pressure
Flu-like symptoms such as nausea, vomiting, weakness, fatigue, loss of appetite
Stunted or poor growth as compared to similar age group peers
Difficulty concentrating and poor school performance

Looking at the list of common symptoms it is easy to see how CKD can go undiagnosed. Parents may want to keep a list of the symptoms the child has as well as how often they happen and how long they last. Parents can encourage their child to talk to them when they don’t feel well. Parents can then follow up with the pediatrician or primary care physician.