From the March 2015 issue

Signs of Kidney Issues in Kids

Pain in the side. Thirsty in the middle of the night. Urinary tract infections. These are just a few of the signs that could accompany kidney disorders in children.

It’s important to be on the look out for these and other symptoms of renal problems. But would you know what to look for? And how do these disorders manifest?

This March, during National Kidney Month, brush up on kidney health in kids – and learn how taking your child to see Children’s Hospital of Michigan’s standout nephrology specialists can make all the difference.

What causes kidney issues?

Many common kidney issues are due to congenital abnormalities, meaning they’re present from birth, explains Dr. Tej Mattoo, chief of pediatric nephrology and hypertension at Children’s Hospital of Michigan.

“It’s not uncommon these days to be diagnosed with some kind of kidney abnormality before the baby is born,” Dr. Mattoo says. Doctors can evaluate the fetus’ kidneys during mom’s ultrasound around 20-24 weeks. This allows parents to connect with nephrology specialists early on.

Mattoo and his pediatric nephrology team at Children’s Hospital of Michigan in Detroit treat patients with a wide range of kidney disorders, including congenital issues, but also conditions such as kidney stones, renal failure, hypertension and more.

“We deal with all kidney problems. Right from kidneys that work for the rest of their lives to the kidneys that don’t work forever, and children need to go on dialysis” – or need a transplant, he says.

Knowing the signs

The symptoms and signs will vary based on the disorder or disease, but parents should take note of potential clues.

One issue doctors at Children’s see is Vesicoureteral Reflux, or VUR – meaning a backflow of urine to the kidneys. This can cause kidney infection and damage. Many times, VUR can manifest as a urinary tract infection, which means docs tend to take UTIs in kids more seriously, Dr. Mattoo says.

Also, “kidney stones are not uncommon in children, either,” Dr. Mattoo says. If parents notice their child has severe flank or side pain, it could be an indication. Dr. Mattoo notes kidney stones can be brought on by a metabolic disease and diet.

Do you know how much your child is growing? “If a child is not growing normally, there is a possibility that it may be because of an underlying kidney problem.”

While it’s not common, Dr. Mattoo says, sometimes bedwetting past age 5 or 6 can be an indicator.

“Bedwetting, as common as it is, if it goes beyond a particular age and there’s no family history, there’s a concern,” he notes, adding there could be some abnormality in bladder function or some other abnormality causing the obstruction of urine flow, or a type of kidney problem causing the production of more urine.

If your kid is thirsty in the middle of the night, take note. While that can be attributed to other issues, Dr. Mattoo says repeatedly waking up looking for fluids at night can be a sign of a kidney problem.

Prevention tips

There are steps parents can take at home to ensure their kids’ kidneys remain healthy.

For starters: “Make sure everyone is well hydrated – especially those with kidney stones,” Dr. Mattoo says. This is extremely important during the summer, and for kids who are active. Hydration is “even more important if the child has diarrhea,” or is vomiting, Dr. Mattoo stresses.
Diet plays a role, too.

“On average, (in) an American diet, we take three to four times more salt than what we need, and children are no expectation.” Sodium intake can contribute to hypertension or high blood pressure, and can aggravate kidney issues like kidney stones.

With diarrhea, bloody stool or “tea-colored” urine, “We may be dealing with something more serious,” Dr. Mattoo says, such as Hemolytic Uremic Syndrome, or HUS, caused by an E. coli infection, which can lead to kidney failure.

Notice red flags? “Pediatricians should be the first ones to hear about the symptoms.” Your child’s primary care physician can then run tests and refer the family to specialists. And if that time comes, the pediatric nephrologists at Children’s Hospital of Michigan are always standing by.

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