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There are a wide range of conditions that can cause kidney disease in children, some of which may require dialysis and, eventually, kidney transplantation. At Children's, our team of experts is trained to diagnose and treat all these conditions, whether common or uncommon.
Dialysis and kidney conditions
Glomerulonephritis is a condition that impairs the ability of your child's kidneys to process urine. It affects the glomeruli, a network of capillaries that provide blood to parts of the kidney known as nephons, which filter urine. Glomerulonephritis can develop as the result of certain infections, such as a "strep throat," or it can arise from a chronic condition. A diagnosis is carefully made through blood and urine tests – sometimes a kidney biopsy is recommended.
Glomerulonephritis care at Children's
At Children's, we treat your child's glomerulonephritis with a variety of different methods depending on the type of glomerulonephritis and you child's symptoms. This may include a recommendation for a fluid restriction or diets low in sodium or potassium, medications for controlling fluid balance and blood pressure, or certain medications to treat the specific type of glomerulonephritis. In more serious cases, treatment might include dialysis.
Nephrotic syndrome is a general condition that is marked by a number of symptoms, including swelling of the face, arms, legs and abdomen, and high levels of protein in the urine and low levels of protein in the blood. The vast majority of the cases in young children are attributed to a common type called "minimal change disease," which has no known cause. Neonates and adolescents are at risk for having other types of nephrotic syndrome.
Treatment at Children's
To best treat your child's nephrotic syndrome, our skilled team seeks to identify the specific type of nephrotic syndrome so we can offer the best treatment. We will also work to alleviate the symptoms of the disease. Treatment options include medication to control blood pressure, corticosteroids, immunosuppressant drugs, or dietary changes to reduce salt that can worsen symptoms of swelling.
Kidney failure – acute or chronic
Kidney failure is the loss of normal kidney function as the result of a significant acute injury or ailment, or a chronic condition. Acute kidney failure appears suddenly, and can sometimes be reversed. Chronic kidney failure develops over time, and results in the gradual loss of function. The symptoms of kidney failure can be very minimal or can include swelling, fatigue, or loss of appetite. When the kidney loses function, the body may accumulate toxins or waste and extra fluid that make your child feel ill. In severe forms, it can be life-threatening. Our goal is to prevent complications by diagnosing kidney failure early and quickly starting medications or dialysis.
Kidney failure care at Children's
When kidney failure is diagnosed, we work to reduce or remove the dangerous levels of fluids, wastes and electrolytes that can develop in children with acute or chronic kidney disease. Those with significant kidney failure typically require a procedure called dialysis which filters fluids, wastes, toxins or electrolytes from the body. In the case of irreversible kidney failure or end-stage renal disease, performing a kidney transplant may be an option.
Hypertension is also known as high blood pressure. In children, it may be caused by genetics, an underlying kidney disease, a weight above the normal range, or in unusual cases, by cardiac or endocrine disease. Sometimes hypertension indicates renovascular disease, which is a blockage or narrowing of the arteries and blood vessels serving the kidney. The low blood flow, in turn, causes the kidney to incorrectly boost the blood pressure for the entire circulatory system.
Hypertension care at Children's
Treatment of hypertension in children focuses on treatment of the underlying condition and lowering the blood pressure to a normal range. Treatment of renovascular disease focuses on increasing blood flow to the kidneys, which we do by opening arteries through angioplasty or stents. If the hypertension is caused by other conditions – such as obesity or metabolic disorder – we partner with you and your child to recommend nutrition and lifestyle changes.
Hematuria refers to the presence of red blood cells in your child's urine. Although the kidney acts as a filter and is supposed to keep blood from entering the urine, diseases or abnormalities can allow leakage. The underlying causes for blood in the urine can include benign condition but also can be a sign of kidney disease, kidney infections or kidney stones.
Hematuria care at Children's
To treat hematuria, our team first identifies the underlying cause, then creates an individualized treatment plan just for your child. Those treatments vary, depending on the diagnosis and may only include careful observation.
Proteinuria – also known as albuminuria – is an excess of protein in your child's urine. Although the condition is usually benign, it can be an indicator of a more serious kidney disorder. Excess protein in the urine indicates that the kidneys are not filtering properly. Symptoms include foamy urine and a swelling of the face, hands, feet and abdomen.
Proteinuria care at Children's
The treatment of proteinuria depends on the cause of the high protein levels. For example, if the cause is glomerulonephritis or nephrotic syndrome, treatments could include dietary changes, immunosuppressant medications, or medications to control blood pressure. In some cases, only observation is required. Our expert diagnostic team works to determine the underlying cause and treats it accordingly.
Polycystic kidney disease (PKD)
Polycystic Kidney Disease (PKD) is a genetic disorder in which fluid-filled cysts grow in your child's kidneys. These cysts can affect kidney function, leading in some cases to kidney failure. The condition can also cause problems in other organs; therefore, children with PKD require a comprehensive evaluation.
Polycystic kidney disease care at Children's
A multi-disciplinary team of nephrologists, hepatologists, geneticists, nurses and dietician forms a unique PKD Clinic here at Children’s and provides consultation and care to those with PKD. At present, there is no cure for PKD and our team focuses on managing symptoms and slowing the rate of disease progression when possible with medicine. Scientists, including those at Children's, are working on establishing new treatments for PKD. In cases where the condition leads to end-stage kidney failure, dialysis or a kidney transplant may be required.
Hemolytic uremic syndrome
Hemolytic uremic syndrome is caused by the abnormal destruction of red blood cells, and typically results from an intestinal infection with a type of E. coli bacteria. It's a common cause of sudden, acute kidney failure in children. Symptoms include pallor, fatigue, irritability, and – as the problem becomes more acute – low urine output, nosebleeds, high blood pressure and swelling of the face, hands, feet and abdomen. There are also "atypical" forms of hemolytic uremic syndrome that can occur in the absence of diarrheal infections; in those cases, genetic causes can be determined.
Hemolytic uremic syndrome care at Children's
Anemia, low blood counts and kidney failure are the main symptoms of hemolytic uremic syndrome. Hypertension, neurological and gastrointestinal complications are also often present. The main treatment is supportive care to address the symptoms. We work to stabilize fluid balance and electrolyte abnormalities in the body. Your child may require a transfusion of red blood cells, or even dialysis, to filter blood and clear waste from the body.
Kidney stones form when substances normally removed from your child's body through urine become concentrated and solidify. These substances include calcium, oxalate and phosphates. Kidney stones are often small enough that they can be passed out of the body naturally through the urine. Large stones, however, can get stuck in the urinary tract, causing blockage and severe pain.
Kidney stones or treatment at Children's
Our treatment for kidney stones depends on the size and nature of the stone or stones. If they are small, your child may simply be given extra fluids to aid in passage and over-the-counter pain medication. If the stone is large, we may use shock waves to break it up or remove it surgically.
Urinary incontinence is leakage of urine, sometimes due to a medical condition that leads to a loss of bladder control. Those conditions include kidney problems, diabetes and urinary tract infections. Most often, urinary incontinence isn't linked to a medical condition and tends to get better over time as your child gets older. Bedwetting and day time wetting can be uncomfortable and cause embarrassment for older children who would not otherwise have loss of bladder control at their age.
Urinary incontinence care at Children's
At Children's, we treat urinary incontinence through our Incontinence and Voiding Dysfunction clinics, called the Voiding Improvement Program, or "VIP." This is a joint clinical service located in both the renal clinics and urology clinics. Our specially trained team is aware of how sensitive this issue can be. We address the anxiety and stress that can accompany urinary incontinence and try to identify and treat the underlying issue.
Recurrent urinary tract infections (UTI)
Urinary tract infections occur when bacteria finds its way to your child's kidneys, bladder and urethra. These infections are common in children, especially girls. Symptoms include pain when urinating, fever, chills, loss of appetite, nausea, and vomiting. Recurrent urinary tract infections can cause kidney damage if left untreated.
Recurrent urinary tract infections care at Children's
In the case of recurrent infections, our team will determine whether certain abnormalities in the urinary tract are contributing to the problem, or whether the infections have caused additional medical issues. Abnormal bladder emptying, or a dysfunction in voiding, and constipation are common reasons for young children to have recurrent urinary tract infections. We will provide advice on how to help your child overcome dysfunctional voiding and help determine whether antibiotics would be helpful to prevent future infections.
Metabolic bone disease
Metabolic bone diseases are a wide range of conditions that can be a result of disruption in normal bone health in chronic illnesses, specific abnormalities in mineral metabolism, nutritional deficiencies in calcium or vitamin D, and some genetic abnormalities. In addition to assessing your child's medical history, we can assess the mineral content of the skeletal bones using a special imaging test called a DEXA scan, or bone densitometry. Patients with unusual or recurrent bone fractures may need to have their bone density checked.
Metabolic bone disease care at Children's
Treatment of your child's metabolic bone disease depends on the root cause. We address specific mineral abnormalities, nutritional deficiencies, kidney issues or hormonal imbalance. Treatment of low bone density may include dietary supplements, physical activity or therapy and sometimes medications to increase the bone mineral content (bisphosphonates).
For established patients with questions about their child’s care, contact the Renal and Hypertension Clinic nurse:
For established Dialysis patients with questions about their child’s care, contact the Dialysis Unit:
To make an appointment for anything other than dialysis, call:
Toll-free (877) 607-5280
To request a dialysis appointment, call:
For those needing assistance for coordinating their care with multiple sub-specialists' appointments, or for attending the PKD Clinic for the first time, please contact our Renal Clinic nurse at (414) 266-2018.