Chronic kidney disease happens when your kidneys and urinary tracts are not working normally.

The functions of healthy kidneys are:

• Filtering blood to produce urine which eliminate waste substances from our blood.
• Regulate blood pressure.
• Regulate production of red cells.
• Regulate acid base balance of the blood.

Some of the known causes of chronic kidney disease are :

• Urine infections leading to scars in the kidneys.
• Blocked outflow of urine from the kidneys leading to kidney damage.
• Kidneys not properly formed from the time of birth.
• Glomerulonephritis (damage that is caused by iInflammation of the kidneys).
• Inherited diseases like Alport’s, polycystic kidneys.

When the kidneys fail to work, it’s called kidney failure. End-stage kidney failure happens when kidney failure is severe, permanent and the child needs dialysis or kidney transplantation to go on living.

How do children with chronic kidney disease present?

Remember children with chronic kidney failure may not have any symptoms until about 80% of their kidney function is lost. Some of the symptoms may include :

• Getting tired more easily than usual
• Pale
• Nausea, vomiting, not eating well
• Poor growth
• Swelling in the legs (oedema)
• High blood pressure

What further problems can it cause?

Progressive loss of renal function will lead to severe renal failure with problems such as :

• Accumulation of fluid in the skin and lungs
• Heart failure from fluid overload
• High blood pressure
• Fits
• Having difficulty concentrating

At this stage the child will need to go onto dialysis without which the child cannot survive.

Treatment and dietary modification

• Diet changes e.g. adequate calories and other various nutrients, restrict dairy products and beans which are high in phosphate.
• Fluid intake needs to be restricted if your child is passing less urine. Offer him ice-cubes to suck to quench his thirst.
• If your child has high blood pressure, you may need to restrict his salt intake.
• Medications that the doctor may prescribe for your child includes :
  • Drugs for blood pressure control
  • Medicines to bind phosphate
  • Supplements for vitamin D
  • Iron and folate supplements

Is there anything that can be done to prevent chronic kidney diseases?

• Treat urine infections promptly.
• Screening for kidney disease if there are family members with inherited kidney disease or end-stage kidney failure.

Rehabilitation

Normal daily activities as much as the child is capable of.