What is chronic kidney disease?
Chronic kidney disease (CKD) is a common condition, affecting 8–16% of the population worldwide. If your child has chronic kidney disease their kidneys don’t function as well as other people’s. Your kidneys filter your blood to remove waste products which are passed in your urine. Kidneys also play an important role in regulating your blood pressure and creating new red blood cells.
CKD can occur as the result of a number of different factors, from genetic to physical. Children with CKD have reduced renal function leading to reductions in calorie intake, electrolytes and production of growth hormone. All of these factors can negatively impact growth in children. For adolescents with CKD, their final height is often less than target height.
Hear advice from other parents whose children are also short in stature, compared with others their age. https://morethanheight.com/en/life-with-growth-disorders/advice-for-early-years-parents-of-a-baby-or-toddler-with-a-growth-disorder/
What causes chronic kidney disease?
The most common causes of chronic kidney disease (CKD) differ with age.
In children, the cause of CKD is most likely a structural condition present from birth that affects their kidneys and urinary tract, collectively known as congenital anomalies of kidney and urinary tract (CAKUT). The underlying cause could also be renal ciliopathies, an umbrella term for a group of disorders characterised by the presence of cysts — abnormal fluid-filled sacs — on your child’s kidneys.
In teenagers, CKD is caused by conditions that cause damage to the kidneys over time. A common cause is chronic glomerulonephritis, characterised by long-term damage to the tiny filters inside your child’s kidneys, often caused by the immune system. Another condition which causes cumulative damage to the kidneys is steroid-resistant nephrotic syndrome (SRNS), as the kidneys can’t effectively filter protein from the urine.
In adults, the cause is more likely to be because of environmental pollutants or other medical conditions such as diabetes and high blood pressure. Damage to the kidneys has accumulated over time, affecting their ability to function correctly.
What are the symptoms of chronic kidney disease?
Symptoms of chronic kidney disease (CKD):
- Acid reflux
- Recurrent vomiting
- Reduced appetite
- Low energy
- Reduced growth rate
- Delayed puberty
- Stunted pubertal growth spurt
- Impaired bone growth
- Short stature
Impaired renal function can impact levels of calcium and phosphate, which are important minerals for bone strength and growth. As kidney function declines, growth becomes more impaired.
Children with CKD don’t receive enough protein, energy and nutrients to support normal growth. The severity of your child’s CKD determines how much their growth is impaired but even mild CKD can have an impact. The earlier the onset of CKD, the greater the impact on adult height, however early diagnosis and intervention can help reverse this effect.
If your child is short in stature, keeping track of their growth can help identify if there is a problem early on. Compare your child’s measurements to the national average to see if they are within a healthy range.
Calculate your child’s growth
It is important to keep track of your child’s growth in order to identify if there is a problem early on. We recommend measuring your child every 6 months, which is now easier, with our simple to use growth calculator.
Are there any complications associated with chronic kidney disease?
Complications of CKD include:
- Anaemia (reduced oxygen-carrying capacity of the blood)
- High blood pressure
- Heart disease
- Vitamin deficiencies including vitamin D, vitamin B12, iron and folate
- Chronic kidney disease-mineral and bone disorder (CKD-MBD) (abnormalities in mineral and bone metabolism due to CKD)
How is chronic kidney disease diagnosed?
Chronic kidney disease (CKD) is defined as abnormalities of kidney structure or function that have been present for more than 3 months.
The main test for CKD your doctor will likely perform is a blood test to measure levels of a waste product called creatinine in your child’s blood. From this value, your doctor can calculate your child’s estimated glomerular filtration rate (eGFR).
A doctor will also perform a urine test to check for blood or protein and also to check the levels of albumin and creatinine present. From this the albumin:creatinine ratio (ACR) can be calculated.
Based on these two values, your doctor will be able to determine the stage of CKD.
Your doctor may recommend imaging of your child’s kidneys using an ultrasound.
It is important you speak to your doctor if you have any concerns about your child’s height. Use this helpful guide on what questions to ask and what to expect from your visit. https://morethanheight.com/en/talk-to-your-doctor/visiting-your-paediatrician/
How fast does chronic kidney disease progress?
Causes of CKD associated with a slower rate of progression are structural changes:
Causes of CKD associated with a faster rate of progression are glomerular diseases:
