Kidney Failure in Children

The two kidneys, each about the size of a fist, are bean-shaped organs located near the middle of the back, just below the rib cage. It functions to remove wastes and excess water from the blood. In addition, the kidneys also
 regulate blood pressure

 balance chemicals like sodium and potassium

 produce hormones to help bones grow and also help stimulate production of red blood cells

Kidney failure in children may occur as a result of direct injury to the kidneys, poisoning, or other diseases that may damage the kidneys.

When the kidneys totally stop working, treatment may involve dialysis or kidney transplantation.
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Causes of Kidney Failure in Children

Kidney failure may either be acute or chronic. Acute diseases develop quickly and can be very serious if not treated promptly. However, most cases of acute kidney failure lasts for only a short time and then goes away once the underlying cause is treated. Chronic diseases, on the other hand, tend to get worse over time.

Acute Kidney Failure

Acute kidney failure may result from direct injuries to the kidneys, loss of blood flow to the kidneys, and poisoning. Acute diseases that may cause kidney failure include hemolytic uremic syndrome and nephrotic syndrome.
Hemolytic uremic syndrome (HUS). HUS is a rare disorder that usually affects children under 10 years of age. It is results from eating foods that have been contaminated by bacteria leading to an infection in the digestive tract. Poisons produced by the bacteria can damage the kidneys, which can cause acute kidney failure.

Nephrotic syndrome. It is a set of signs that may point to kidney problem. Nephrotic syndrome is not a disease itself. However, it can be the first sign of a disease that damages certain structures in the kidney. A child with this condition can have high levels of protein in the urine; swelling around the eyes, legs, and belly; less frequent urination; and weight gain from excess water.
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Chronic Kidney Failure

A variety of conditions can lead to chronic kidney failure in children. Often, the disease goes unnoticed for many years until the kidneys have been permanently damaged. Treatment may delay the progression of some diseases. However, in many cases of chronic kidney disease, the child will eventually need dialysis or transplantation.

Some diseases or conditions that can lead to chronic kidney failure include:
Birth defects. Some babies are born with abnormally formed kidneys or without kidneys.

Blocked urine flow and reflux. Conditions or abnormalities that cause blockage of urine flow can cause urine to back up (reflux) and damage the kidney.

Inherited diseases. Hereditary diseases such as polycystic kidney disease (PKD) and Alport syndrome can cause kidney failure in children.

Glomerular diseases. Some conditions can damage the glomeruli—tiny filtering units in the kidney. Severe damage to the glomeruli can cause kidney failure.

Systemic diseases. Conditions such as diabetes and lupus can cause damage to the kidneys.
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Treatment of Kidney Failure in Children

Managing acute kidney failure involves treating the underlying cause. Once the underlying cause has been treated, kidney functions usually return to normal.

If a child’s kidneys have been totally damaged and fail completely, treatment to replace the work of the kidneys is necessary. Available treatment options are dialysis and transplantation.

Dialysis is a way to remove the toxins, wastes, and extra water from the blood of patients with kidney failure.

Kidney Transplantation

In kidney transplantation, the surgeon places a healthy kidney in the child’s body. The kidney may come either from a live donor or from someone who has just died. People who undergo transplantation must take medicines, called immunosuppressive drugs, to prevent the body’s immune system from rejecting the transplanted organ. However, taking these drugs can make the patient prone to infections.
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National Kidney and Urologic Diseases Information Clearinghouse (February 2008). Childhood Nephrotic Syndrome (NIH Publication No. 08—4695). National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), Bethesda, MD. Web URL: http://kidney.niddk.nih.gov/kudiseases/pubs/prostatitis/index.htm. Accessed: October 12, 2008

National Kidney and Urologic Diseases Information Clearinghouse (June 2006). Overview of Kidney Diseases in Children (NIH Publication No. 06—5167). National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), Bethesda, MD. Web URL: http://kidney.niddk.nih.gov/kudiseases/pubs/childkidneydiseases/overview/index.htm. Accessed: October 12, 2008

National Kidney and Urologic Diseases Information Clearinghouse (December 2005). Hemolytic Uremic Syndrome (NIH Publication No. 06—4570). National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), Bethesda, MD. Web URL: http://kidney.niddk.nih.gov/kudiseases/pubs/childkidneydiseases/hemolytic_uremic_syndrome/index.htm. Accessed: October 12, 2008

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