Renal Failure

Renal failure occurs when your child’s kidneys can no longer work well enough to keep the body healthy. The kidneys normally remove waste and extra fluid from the blood, balance minerals and electrolytes, and help control blood pressure and other important functions. When the kidneys stop working properly, waste and fluid can build up in the body and require prompt medical care.

Renal failure is classified as acute or chronic.

Acute renal failure begins suddenly and may develop over hours or days, often because of an illness, infection, dehydration or another injury to the kidneys.

Chronic kidney disease (CKD) develops slowly, and may lead to kidney failure. This happens in stages.

What Causes Kidney Failure?

Some causes of acute renal failure include:

• Restricted or interrupted blood or oxygen flow to the kidneys
• Urinary tract blockage
• Certain medications
• Hemolytic uremic syndrome
• Glomerulonephritis

Some causes of chronic renal failure include:

• Untreated acute renal failure
• Untreated diabetes
• Extended urinary tract blockage
• Alport syndrome
• Polycystic kidney disease
• Nephrotic syndrome
• Cystinosis

Symptoms of Renal Failure

Some general symptoms of renal failure may include:

• Swelling
• Vomiting
• Changes in urine frequency
• Pale appearance
• Mass in the stomach

Symptoms of acute and chronic renal failure may differ.

Symptoms of acute renal failure may include:

• Fever
• Bleeding
• Bloody diarrhea
• Rash
• Stomach pain
• Eye swelling

Symptoms of chronic renal failure may include:

• Change in appetite
• Frequent urinary tract infections
• Urinary incontinence
• Fatigue or general discomfort
• Bone pain
• Headache
• Stunted growth
• Bad breath
• Hearing problems
• Irritability
• Poor muscle tone
• Change in mental alertness

Diagnosis of Pediatric Renal Failure

Diagnosing renal failure starts with understanding your child’s symptoms, medical history and kidney function. Your child’s care team may order blood tests to measure waste products such as creatinine and check electrolyte levels. Urine tests can look for protein, blood, infection or other signs of kidney problems. Depending on your child’s condition, additional testing may include an ultrasound or other imaging studies to look at the kidneys and urinary tract. In some cases, genetic testing or a kidney biopsy may help determine what is causing kidney damage.

Treatment of Pediatric Renal Failure

Treatment depends on whether your child has acute or chronic renal failure, what caused it, and how much kidney function has been lost. Acute renal failure may improve when the underlying cause is treated. Care may include fluids, medications, nutritional support or treatment for an infection, along with close monitoring of kidney function and fluid levels. Children with chronic renal failure may need ongoing medications, dietary changes and treatment for complications such as high blood pressure, anemia or problems with growth and bone health.

When the kidneys can no longer adequately support the body, dialysis or a kidney transplant may be needed. Pediatric kidney specialists work closely with your family to determine the best treatment for your child and provide care as their needs change. For children who need a transplant, care may include evaluation for transplant, donor matching, preparation for surgery and lifelong follow-up after transplantation.