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Kidney disease

Background

Each kidney contains about one million nephrons, or filtering units, which continuously filter the blood to remove waste products and excess fluid from the body. Kidney disease can result in two different sorts of problems:

  • kidney failure occurs when the function of the filtering unit is reduced, and waste products start to accumulate in the body. In acute kidney (renal) failure, there is a sudden loss of kidney function, whereas in chronic kidney failure the decline in kidney function is more gradual
  • nephrotic syndrome describes the situation when the filters allow lots of protein (mostly albumin) to leak into the urine, resulting in low levels of proteins in the blood.

Causes of kidney failure in children include:

  • abnormalities in the development of the kidneys or urinary tract. These may be inherited, or occur in children with no family history of kidney disease. The terms dysplasia or hypoplasia are used to describe a failure of the kidneys to develop or grow properly
  • vesico-ureteric reflux describes a condition in which urine can flow back up into the kidneys as a child empties their bladder. This can cause scarring to the kidneys, particularly if the urine is infected.

In cystic kidney disease, fluid filled sacs, or cysts, develop in the kidney, interfering with normal kidney function. The commonest form is adult polycystic disease (see entry Polycystic Kidney disease), which is inherited as an autosomal dominant. It is a common cause of kidney failure in adults, but cysts rarely cause problems in childhood. In autosomal recessive polycystic kidney disease, cysts can develop before birth, leading to kidney failure in infants and children. The condition may be associated with liver problems.

Glomerulonephritis describes inflammation of the glomeruli, or filters of the kidney. Often, the cause or trigger is unknown. In haemolytic uraemic syndrome damage to the kidneys often follows infection with a bacterium called E. coli.

Diabetes and kidney disease View Diabetes and kidney disease

Medical text written October 2000 by Dr J Bradley. Additional material on diabetes and kidney disease written February 2003 by Contact a Family. Approved February 2003 by the Medical Advisory Board (Consultant Nephrologist) of the National Kidney Research Fund, UK. Last reviewed May 2005 by Dr J Bradley, Consultant Nephrologist, Director of Renal Medicine, Addenbrooke's Hospital, Cambridge, UK.

 

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