Chronic kidney disease in children is a lasting reduction in kidney function or a structural kidney abnormality present for more than 3 months. It is much rarer than in adults and has different causes: most children are born with the underlying problem.
Because children are still growing, CKD affects height, bone strength, nutrition, puberty and schooling as well as the kidneys. Care comes from a paediatric nephrology team with dietitians, nurses and psychologists, and it continues through to transfer to adult services.
Symptome
- Poor growth and short stature
- Poor appetite, vomiting or faltering weight in infants
- Excessive thirst, passing large volumes of urine, or bedwetting that returns
- Repeated urinary tract infections
- Tiredness and pallor
- Swelling around the eyes or in the legs
- High blood pressure, headaches
- Bone pain, bowed legs or other bone deformity
- Findings on antenatal ultrasound before any symptoms appear
Ursachen und Risikofaktoren
About half to two thirds of cases are due to congenital anomalies of the kidneys and urinary tract: small or dysplastic kidneys, posterior urethral valves in boys, severe reflux and obstruction. Inherited conditions come next, including nephronophthisis, polycystic kidney disease, Alport syndrome and cystinosis. In older children, glomerular diseases such as focal segmental glomerulosclerosis, steroid-resistant nephrotic syndrome and lupus become more common. Haemolytic uraemic syndrome and other severe acute injuries can leave lasting damage.
Wie es diagnostiziert wird
- Creatinine with a paediatric eGFR formula: The bedside Schwartz equation uses height; adult formulas are inaccurate in children.
- Urine protein and urinalysis: Protein to creatinine ratio on a first morning sample.
- Kidney and bladder ultrasound: Shows kidney size for age, scarring, dilatation and bladder wall thickness.
- Voiding cystourethrogram and DMSA or MAG3 scans: Assess reflux, valves, scarring and drainage.
- Growth charts, bone profile and PTH: Height, weight and head circumference plotted at every visit; calcium, phosphate, vitamin D and parathyroid hormone for bone health.
- Genetic testing: Panel testing finds a cause in a growing share of children and informs family planning and transplant decisions.
- Blood pressure measurement: With the correct cuff size, often with 24 hour ambulatory monitoring.
Behandlungsmöglichkeiten
- Nutrition support: Adequate calories are essential for growth; many infants need supplemental or tube feeding. Protein is not restricted in growing children.
- Salt, water and bicarbonate supplements: Children with dysplastic kidneys often lose salt and water and need extra, the opposite of adult advice.
- Blood pressure and proteinuria control: ACE inhibitors or ARBs, aiming for blood pressure in the lower half of the range for age.
- Bone and mineral management: Vitamin D, phosphate control and active vitamin D analogues.
- Anaemia treatment: Iron and erythropoiesis stimulating agents.
- Growth hormone: Daily injections for children who remain short despite good nutrition and metabolic control.
- Urological surgery: Valve ablation, reflux correction or bladder management to protect remaining function.
- Dialysis and transplant: Peritoneal dialysis at home is usual for young children. Transplantation, often from a parent, is the preferred treatment for kidney failure.
Wenn es dringend ist
Take your child to the nearest emergency department for fever with lethargy, persistent vomiting or diarrhoea (salt-losing children dehydrate fast), very little urine, severe headache or visual change, seizures, breathing difficulty or sudden swelling. Children on peritoneal dialysis with cloudy fluid or abdominal pain need same day care.
Reisen nach Türkiye zur Behandlung
A child with CKD needs a local paediatric kidney team seen every 1 to 3 months, working with the school and family. No trip replaces that, and unwell children should not travel for care. A visit may be appropriate for a second opinion with genetic diagnosis, a planned urological operation, or living related donor transplantation, which involves several weeks' stay, ethics committee approval of the donor relationship under Turkish law, and firm arrangements for follow-up at home.
Senden Sie Ihre Berichte, Scans und eine kurze Geschichte und eine Clinic-Y Koordinator Antworten innerhalb von 24 Stunden mit geeigneten Teams und schriftlich, All-inclusive Vorschläge nebeneinander. Die Überprüfung Ihres Falls ist kostenlos.
Häufig gestellte Fragen
Will my child need a transplant?
Not all do. Children with mild CKD from birth may stay stable for years, with function often falling faster around puberty. The team will prepare you well ahead.
Why is my child told to take extra salt?
Malformed kidneys often cannot hold on to salt and water. Restricting them can impair growth and kidney function.
Can my child attend school and play sport?
Yes, and both are encouraged. Contact sport needs discussion when there is a single kidney or after a transplant.
Can a parent donate a kidney?
Often, subject to blood group, tissue compatibility and the parent's own health. An adult kidney can usually be placed once the child weighs about 10 kilograms.