Childhood Kidney Diseases

The most common kidney diseases in children are present at birth. They include:

Posterior urethral valve obstruction: This narrowing or obstruction of the urethra affects only boys. It can be diagnosed before the baby is born or just afterwards and treated with surgery.

Fetal hydronephrosis: This enlargement of one or both of the kidneys is caused by either an obstruction in the developing urinary tract or a condition called vesicoureteral reflux (VUR) in which urine abnormally flows backward (or refluxes) from the bladder into the ureters. Fetal hydronephrosis is usually diagnosed before the child is born and treatment varies widely. In some cases the condition only requires ongoing monitoring; in others, surgery must be done to clear the obstruction from the urinary tract.

Polycystic kidney disease (PKD): This is a condition in which many fluid-filled cysts develop in both kidneys. The cysts can multiply so much and grow so large that they lead to kidney failure. Most forms of PKD are inherited. Doctors can diagnose the condition before or after the child is born. In some cases, there are no symptoms; in others, PKD can lead to urinary tract infections, kidney stones, and high blood pressure. Treatment for PKD also varies widely. In some cases, PKD can be managed with dietary changes; in others, it requires a kidney transplant or dialysis, which is a medical treatment that helps the body filter waste when the kidneys can't do the job.

Multicystic kidney disease: This is when large cysts develop in a kidney that hasn't developed properly, eventually causing it to stop functioning. (While PKD always affects both kidneys, multicystic kidney disease usually affects only one kidney.) Usually diagnosed before a baby is born, this condition can lead to kidney failure. Currently, there is no cure, but doctors can manage it by preventing and treating infections, maintaining blood pressure, and addressing any issues that arise with surgery.

Renal tubular acidosis: This is a condition in which the kidneys do not properly regulate the amount of acid in the body. It can cause kidney stones and affect a child's growth, but usually can be treated with medications.

Wilms tumor: This is a type of childhood cancer that involves the kidney. It is typically diagnosed within the first 2 years of life and can be treated with surgery and chemotherapy.

Glomerulonephritis: This is an inflammation or infection of the glomeruli, which are parts of the nephrons that contain tiny blood vessels. It can affect the kidney's ability to properly filter out waste and can lead to swelling, blood in the urine, and a reduced amount of urine production. Some cases can be treated with medication, while others require dialysis or a kidney transplant.

Nephrotic syndrome: This occurs when the body loses large amounts of protein through the urine, typically because of some sort of change in the nephrons. It is usually diagnosed after the child is 1 year old. Swelling of the face, abdomen, and extremities are among the main symptoms, and are often relieved with medication.

Congenital problems with the urinary tract: As a child develops in the womb, a part of the urinary tract can grow to an abnormal size or in an abnormal shape or position. These problems include:

* duplication of the ureters , in which a kidney has two ureters instead of one. This can lead to urinary tract infections over time and can be treated with medication or occasionally with surgery.

* horseshoe kidney , where the two kidneys are fused (connected) into one arched kidney that usually functions normally, but is more prone to develop problems later in life. An uncomplicated horseshoe kidney does not need medical or surgical treatment, but it does need to be checked regularly by doctors.

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