HealthInfo Canterbury
Kidney problems in children
The kidneys are part of the urinary tract system. They are two bean-shaped organs that sit just below your ribs, one on each side of your spine. Their job is to remove waste and water from your blood. The extra fluid and waste that they remove are passed along to your bladder through tubes (ureters) and then out of the body as urine through another tube (urethra).
Most people are born with two kidneys, though some people have just one. If you only have one kidney, and it's healthy, you won't have any problems.
This page has information about some of the problems that tamariki (children) can get with their kidneys. See the pages in the Kidneys section to learn more about healthy kidneys and how they work
Causes of kidney problems in children
Many different conditions can affect the kidneys of tamariki children . Some are temporary and can be treated, while others can have more long-term effects. Causes of kidney problems for tamariki include:
- birth defects (congenital defects), which happen while a pēpi (baby) is developing in the mother's womb. These may be found during a routine ultrasound scan during pregnancy, or discovered after birth.
- urinary reflux, where the urine flows back from your bladder to your kidneys. This can cause scarring in your kidneys.
- blockages along the urinary tract.
- frequent urinary tract infections.
Some diseases that can cause kidney damage include:
- hereditary diseases (diseases passed from parents to their tamariki) such as polycystic kidney disease or Alport syndrome.
- glomerulonephritis – this group of diseases affects the filtering system of the kidneys and includes minimal change disease or focal segmental glomerulosclerosis.
- diseases that affect the whole body, such as lupus and diabetes.
These diseases can all damage the kidneys' filtering system, causing them to leak protein. If too much protein is leaked it can cause nephrotic syndrome.
Some diseases of the kidney don't show up until later in life or after a tamaiti (child) has a bacterial infection or an immune disorder
Diagnosing kidney problems in children
There are few if any signs of early kidney disease. Some tamariki have mild puffiness around their eyes and face, or foamy wee (urine).
As kidney problems progress, they may have symptoms including:
- changes in how often they have to wee (pass urine). These can include weeing more or less often, not being able to control the urge to wee, getting up at night to wee, or pain when they wee
- bedwetting
- not wanting to eat much (a poor appetite), feeling sick
- swollen hands and feet
- low energy and feeling tired
Make an appointment to see your GP if your tamaiti child has any of these symptoms. Your GP will take a history of the symptoms, do an examination and may check the blood pressure of your tamaiti as it is very important that it is in a healthy range.
They may do several tests to see if there really is a kidney problem. These tests might include:
- urine tests, to check for infection and check for protein in their wee. When your kidneys aren't working as well as they should, protein can leak into your wee
- blood tests, to check for signs of infection and how well their kidneys are working. These will include a test for creatinine, which is a waste product your kidneys usually filter out of your blood. If your tamaiti has more creatinine in their blood, it means their kidneys are not working as well as they should
- a kidney ultrasound, which is a scan that shows the size, shape, and structure of their kidneys
- a kidney (renal) biopsy, which means taking a tiny piece (sample) of their kidney to help find the cause of the problem, and see how much damage there is
- nuclear scans such as a DMSA, which can take pictures of the kidneys
- micturating cysto-urethrogram (MCU) – a special test that looks inside the urethra (tube they wee through) while your tamaiti is weeing.
Your GP may refer your tamaiti to a doctor that specialises in children's health (paediatrician).
Treating kidney problems in children
The treatment will depend on what is causing the kidney problems for your tamaiti. For example, if they have an infection, they will be given antibiotics to treat the infection. If they have a birth defect, it may be possible to fix the defect with surgery. If their kidneys are damaged, treatment will aim to control the symptoms and stop or slow down any further damage.
HealthInfo recommends the following pages
- Kidney Health New Zealand
This New Zealand website has good information about kidney disease, kidney donation and transplant, and patient support.
- Kidney Kids NZ
Kidney Kids NZ has been set up by parents to meet the needs of children, and the families of children, who have kidney disorders.
- InfoKID
Information for parents and carers about kidney conditions, tests and treatments in babies, children and young people.
Written by HealthInfo clinical advisers. Last reviewed January 2022.
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Review key: HIKPC-119687
