Kidney Problems in Childhood
The health of children is of paramount importance to every parent. It can be particularly challenging for parents to confront the fact that their child’s vital organ, the kidney, is not functioning optimally. Alongside this, it is also a challenge for parents to teach their children how to live with this situation.
Thousands of children in the country suffer from kidney diseases, and a significant number of young children require dialysis treatment. Kidney transplantation, which is the most serious solution, is already available in childhood, and there are numerous successful cases known where young patients have undergone this procedure. Doctors monitor the development of the fetus’s kidneys even during pregnancy, and if they detect any abnormalities, they report them immediately.
Recognizing kidney diseases and developmental disorders is crucial for preserving a child’s health, making the collaboration between parents and doctors essential for appropriate treatment and improving the child’s quality of life.
Developmental Disorders and Kidney Diseases in Childhood
Among kidney diseases, the most common developmental disorder is hydronephrosis, which results from a narrowing in the urinary drainage system. This problem often resolves on its own, but in certain cases, surgical intervention may be necessary. Urinary tract disorders are particularly important as they can predispose children to infections. This issue particularly affects boys in infancy and early childhood, while girls may experience infections more frequently during adolescence.
Urinary tract infections are among the most common kidney diseases in childhood. These are usually of bacterial origin, with the most common pathogen being E. coli, which is normally present in the intestinal flora. The occurrence of infections is closely related to the child’s environment, and treatment typically consists of a course of antibiotics, although more severe cases may require surgical intervention. Problems related to urine retention, such as bedwetting, also fall under the field of pediatric nephrology and constitute a significant portion of kidney disorders.
Characteristics of Urinary Tract Infections in Childhood
Urinary tract infections are the second most common bacterial infections among children. This category includes cystitis and pyelonephritis. Generally, serious organ problems are not found behind urinary tract infections; the symptoms are often attributed to transient functional deviations or psychological factors. Examination typically becomes necessary after the age of 5, but in the presence of daytime symptoms, it may be warranted earlier.
Rarer disorders include a duplicated renal pelvis, which is an anatomical anomaly but usually does not cause severe consequences. Cystic kidney diseases detected during ultrasound examinations require thorough investigation, as these issues can also affect the child’s health. Kidney tumors can also occur, although they are much less common than in adults. The formation of kidney stones can also cause severe symptoms, such as cramping pain and hematuria.
Dialysis and Kidney Transplantation in Children
End-stage renal failure is relatively rare among children. Approximately 8-12 children enter this stage each year, requiring renal replacement therapy. Chronic renal failure generally develops gradually, and clinical symptoms often appear late, leading to delayed recognition of the problem.
International statistics can determine the proportion of new children requiring renal replacement therapy. In Western countries, there are 3-6 new cases per year for every 1 million residents under 15 years of age. In recent years, the overall numbers have not changed dramatically, but variations can be observed in the distribution among age groups. In children under 5 years, treatment is increasingly starting, while there has been a slight decrease in the 5-15 age group.
For children with chronic renal failure, renal replacement therapies, including dialysis and assessment for transplant eligibility, are available.
Dialysis and Kidney Transplantation in Hungary
The functioning of the kidneys is vital for maintaining the body’s salt, water, and acid-base balance, as well as for eliminating toxins. The function of the kidneys can be impaired due to various medical conditions, and if this function decreases to a critical level, medical intervention is necessary to save the life.
In Hungary, pediatric dialysis and kidney transplantation have been available for decades. The first pediatric dialysis was performed in Szeged, followed by centers in Budapest and the countryside. Pediatric kidney transplantation is now a routine procedure supported by living donor programs. Living donation offers optimal conditions for kidney transplantation since kidneys transplanted this way are generally more viable.
About 15 children require kidney transplantation each year in Hungary. Statistics indicate that there has been active search for donors in recent years, and joining the Eurotransplant system may also help increase the number of donors.
Timely recognition of kidney diseases is particularly important in childhood. Alongside continuous medical monitoring, the family must also adapt to the illness, as in many cases it requires a new lifestyle and way of living that must be accepted not only by the parents but also by the children.
