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There are many ways you can help children and their families get the care they need.
The first step in treating your child is forming an accurate and complete diagnosis. It’s important to remember that diagnosis for chronic kidney disease can be thought of in two ways: diagnostic tests that indicate a problem with your child’s kidneys, and kidney function tests that tell us how well they are working.
Since children with chronic kidney disease rarely show symptoms in the beginning, it often goes undiagnosed until its later stages. Your child’s pediatrician should be monitoring for it during regular check-ups by:
The diagnostic process often begins when your child’s pediatrician notices protein in your child’s urine during a routine urinalysis, a sign (though not a conclusive one) of kidney disease.
If your child has the signs associated with nephrotic syndrome (NS), her doctor will most likely start her on steroid treatment. The majority (80 to 90 percent) of children respond to steroid treatment, and within eight to 12 weeks, the symptoms disappear. This is known as “minimal change nephrotic syndrome,” and it can come and go, like asthma. Many children outgrow minimal change nephrotic syndrome after a few years.
NS that doesn’t respond to steroid treatment is thought to have a different cause. If your child’s NS doesn’t respond to steroid treatment, her doctors may order further diagnostic tests including:
There are two main ways to test your child’s kidney functioning: by measuring her creatinine level and glomerular filtration rate (GFR).
Creatinine is a waste product that the body makes in a constant amount (depending on muscle mass) each day. It can only leave the body through the kidneys, so a higher creatinine level indicates decreased kidney functioning. Creatinine level is checked through a simple blood test.
Glomerular Filtration Rate Test is a measure of how efficiently your kidneys are able to filter your blood.
Other blood tests may be used to check cholesterol level, and for the level of a blood protein called albumin.
In addition to the results of these tests, we also look at your child’s symptoms and how he feels. Despite having a high creatinine level, if he’s feeling well and going to school, it’s probably not time for her to go on dialysis or have a kidney transplant.
After we complete all necessary tests, our experts meet to review and discuss what they have learned about your child's condition. Then we’ll meet with you and your family to discuss the results and outline the best treatment options.
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”