When Your Child Has a Kidney Problem

Children with a kidney problem almost always develop the problem at or shortly after birth.  These kidney disorders result from a failure of the urinary tract to develop normally.  One of the most common kidney diseases is called posterior urethral valve obstruction.  This occurs because there is a narrowing or blockage of the tube or urethra that exits the bladder.  This condition only occurs in boys and can be diagnosed before birth when the volume of fluid around the fetus is low or shortly after birth.  This condition is treated with emergency surgery and does not generally have further complications.

Fetal hydronephrosis is another kidney problem in children that results in an enlargement of one or both of the kidneys.  The enlargement is caused by a blockage in the urinary tract, usually in the ureters.  The urine backs up into the kidneys and puts pressure on the growing kidneys.  This can be diagnosed before birth through an ultrasound.  Treatment is focused on relieving the blockage and preventing backflow of urine.

Polycystic kidney disease is another kidney problem that is generally inherited.  Small fluid filled cysts develop in both kidneys and take the place of normal kidney tissues.  It can be diagnosed at birth or can show up after the child is born.  This kidney problem can lead to urinary track infections, stones in the kidneys and high blood pressure.  Sometimes dietary changes can partially help the condition but usually, the patient needs dialysis or a kidney transplant.

Another childhood kidney problem is multicystic kidney disease.  This occurs when large cysts develop in a poorly functioning kidney.  Usually only one kidney is affected.  The condition leads to kidney failure in the affected kidney.  The treatment is focused on keeping the blood pressure down and, in some cases, removal of the damaged kidney needs to occur.    

Rarer kidney problems include renal tubular acidosis, where the kidneys don’t regulate the amount of acid in the system, Wilms tumor, which is a form of childhood cancer of the kidney and glomerulonephritis or an inflammation of parts of the kidneys that contain tiny blood vessels.  The area gets swollen and fails to filter properly.  Blood can show up in the urine.  Nephrotic syndrome is another kidney problem that occurs when the body filters out too much protein in the urine and there isn’t enough protein in the blood.  This leads to swelling of the body with extra fluids.

Another odd kidney problem occurring before birth is a condition known as duplication of the ureters, where there are two ureters on one side of the bladder instead of one.  Other congenital malformations include having a horseshoe kidney, where the two kidneys are fused together in the middle of the body.

High blood pressure can come from a kidney problem in childhood.  The damaged kidney puts out too much of a hormone called renin, which triggers other hormones that result in high blood pressure.     Kidney stones can occur in childhood, usually from a hereditary predisposition to kidney stones.  Kidney stones, and several of the other kidney problems in children can lead to infections of the urinary tract, some of which can be dangerous.