Chronic Kidney Disease | Symptoms & Causes

What causes chronic kidney disease in children?

It’s a complicated question. Remember that chronic kidney disease (CKD) refers to a state in which the kidneys aren’t working properly. This could be due to a malformation, a build-up of scar tissue on the kidneys or other causes.

About half of all childhood cases of CKD are due to congenital (present at birth) abnormalities of the kidneys or bladder, such as:

  • obstruction to kidneys that can prevent blood from getting to them
  • reflux from bladder back up into kidneys that can cause chronic infection
  • dysplastic kidneys that were never formed correctly, and cannot function as they should

For the other half of children with CKD, it may be caused by one or more acquired conditions. Many cases are linked to nephrotic syndrome, a collection of symptoms and signs centered around four major components:

  • protein in urine
  • low levels of protein in the blood since it’s being lost in the urine
  • swelling in the body (edema), particularly around the ankles and eyes. This happens because the proteins that hold water inside your child’s blood vessels are lost in the urine, so water seeps into the body’s tissues.
  • high cholesterol - to compensate for the low levels of protein, the body makes fat in the form of cholesterol.

Focal segmental glomerulosclerosis (FSGS)

Sometimes nephrotic syndrome is caused by a serious condition called focal segmental glomerulosclerosis (FSGS). FSGS causes scarring on the parts of the kidneys that filter the blood. It’s challenging to treat because:

  • its exact causes are unclear.
  • it can recur in a newly-transplanted kidney, sometimes within hours.

FSGS and other conditions that cause scarring of the kidney tend to worsen over time because scar tissue causes the kidneys to have to work harder, which in turn causes more scar tissue to form.

Children’s researcher Elizabeth J. Brown, MD, has discovered a gene linked with FSGS. These discoveries are critical to determining what causes the disease, and how an effective treatment can be developed.

Other factors that may cause CKD include:

It’s important to note that the causes of CKD in adults tend to be different. Most often, adult CKD is caused by diabetes, hypertension and simply aging.

What are the symptoms of CKD?

CKD is challenging to diagnose early because in its earliest stages, it often doesn’t cause visible symptoms. When symptoms do appear, they’re often non-specific, and don’t necessarily indicate a problem with your child’s kidneys. Some of these symptoms include:

  • fatigue
  • problems concentrating
  • trouble sleeping, restless leg syndrome
  • generally feeling unwell
  • fever
  • loss of appetite

Children usually aren’t in pain, unless they have an infection in the kidneys or another organ.