Kidney Failure PDF

kidney failure What is pediatric kidney failure? Ø The kidneys normally remove waste and extra fluid from a child’s body by making urine. Ø When the kidneys don’t do their job, waste and other substances build up in the blood instead of being removed through the urine There are two types o...

kidney failure What is pediatric kidney failure? Ø The kidneys normally remove waste and extra fluid from a child’s body by making urine. Ø When the kidneys don’t do their job, waste and other substances build up in the blood instead of being removed through the urine There are two types of renal failure: Acute renal failure § Happens suddenly. § It can be caused by a medical illness that affects the entire body, kidney infection, injury, or medications. § Once the cause is treated, the kidneys usually heal. § Sometimes, a blood-filtering treatment called dialysis is used to clear a child’s body of toxins that built up while the kidneys were not working properly. Chronic renal failure Ø Happens over time and is usually permanent. Ø It can be caused by acute renal failure that doesn’t improve, a birth defect or a chronic kidney disease. Ø Medication and diet can slow the decline in the child’s kidney function. Ø Ultimately, however, the child will likely need a kidney transplant to treat chronic renal failure. Causes Ø In adults, kidney failure is commonly caused by diabetes and high blood pressure. Ø In children, the causes of kidney failure are different. Ø Certain genetic disorders, or hereditary diseases, run in families and can harm the kidneys. Examples include polycystic kidney disease and Alport syndrome. Ø Polycystic kidney disease (PKD) is a genetic disorder that causes the growth of numerous fluid-filled cysts in the kidneys. These cysts can reduce kidney function, leading to kidney failure. Ø Alport syndrome is a rare, genetic disorder that damages the tiny blood vessels called glomeruli in a child’s kidneys, and its symptoms are characterized by kidney disease, hearing loss, and eye abnormalities. Ø Birth defects of the kidneys or urinary tract can prevent a child’s kidneys from working properly. Ø Glomerular diseases, such as glomerulonephritis, can damage the filters in the kidneys. Click to add text Click to add text Who gets pediatric kidney failure? Ø Kidney failure can happen to anyone, including children and teens of all ages and ethnicities. Ø It is not genetic, though some genetic conditions can cause it. Signs and symptoms ü Sometimes there are no signs of kidney failure. ü When kidney failure is mild, it often goes undetected unless doctors do testing for another reason. ü Signs also depend on the cause of the kidney failure. ü Typical signs of kidney failure can include: Decreased urine output Fluid retention, leading to body swelling Decreased energy Paleness caused by anemia Additional, non-specific symptoms can include: Poor appetite Vomiting Headaches Stunted growth Urinary tract infections Incontinence (inability to hold urine) Fever Rash Bloody diarrhea Abdominal mass (a noticeable lump in the abdomen) Diagnosis § In addition to a physical examination and complete medical history, your child's doctor may order the following diagnostic tests: Blood tests. Blood tests will determine blood cell counts, electrolyte levels, and kidney function. Urine tests. Chest X-ray. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.  Bone scan. A nuclear imaging method to evaluate any degenerative and/or arthritic changes in the joints; to detect bone diseases and tumors; to determine the cause of bone pain or inflammation. Renal ultrasound (also called sonography). § A n o n i nva s i v e te s t i n w h i c h a t r a n s d u c e r i s p a s s e d ov e r t h e kidney producing sound waves which bounce off the kidney, transmitting a picture of the organ on a video screen. § The test is used to determine the size and shape of the kidney, and to detect a mass, kidney stone, cyst, or other obstruction or abnormalities.  Electrocardiogram (ECG or EKG). This test records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and detects heart muscle damage. Renal biopsy. This procedure involves the removal of tissue samples (with a needle or during surgery) from the body for examination under a microscope. Treatment Specific treatment for renal failure will be determined by your child's doctor based on: The child's age, overall health, and medical history The extent of the disease The type of disease (acute or chronic) The child's tolerance for specific medications, procedures, or therapies Expectations for the course of the disease Hemodialysis uses a special filter called a dialyzer to remove wastes and extra fluid from the blood. § Treatment of acute renal failure depends on the underlying cause. § Treatment may include: Hospitalization Administration of intravenous (IV) fluids in large volumes (to replace depleted blood volume) Diuretic therapy or medications (to increase urine output) Close monitoring of important electrolytes such as potassium, sodium, and calcium. Medications (to control blood pressure) Specific diet requirements. § In some cases, children may develop severe electrolyte disturbances and toxic levels of certain waste products normally eliminated by the kidneys. § Children may also develop fluid overload. Dialysis may be indicated in these cases. § Treatment of chronic renal failure depends on the degree of kidney function that remains. § Treatment may include: ü Medications (to help with growth, prevent bone density loss, and/or to treat anemia). ü Diuretic therapy or medications (to increase urine output) ü Specific diet restrictions ü Dialysis ü Kidney Treating complications Anemia: Damaged kidneys may not produce enough of the hormone erythropoietin that helps make red blood cells. Your child may need erythropoietin injections to replace this hormone. Growth problems: The kidneys normally help to regulate phosphorus and calcium levels in your child’s body, which affects bone growth. Medication or injections can help your child grow and improve bone health. Weakened immune system: When waste builds up in your child’s blood, it can make your child more vulnerable to illness. Vaccinations can prevent certain infections. Learning or developmental difficulties: Waste in the blood can slow down nerve and brain function. This may make it hard for the child to concentrate or develop certain skills​. What's life like after a kidney transplant? Ø Once these patients recover from their transplant surgery, we expect kids who get kidney transplants to live full, normal lives. Ø They will need to take medicine for the rest of their lives to make sure their body's immune system doesn't fight their new kidney, and they will need regular follow up with laboratory testing. kidney transplant THANK YOU