During March, which is kidney awareness month, doctors at
Hopkins Children's Center want to remind parents that
timely detection of kidney problems in early childhood and
adolescence is the best way to curb kidney damage and even
reverse some of it.
"Kidney disease occurs more often than we think, but
it is also more treatable than we used to think, especially
when caught early," says Barbara Fivush, director of
nephrology at the Children's Center. "Children and
adolescents should be monitored carefully because kidney
disease that seems to suddenly strike young adults often
has its roots in childhood."
Kidney disease develops silently and often manifests
its presence only when it's too late to stop the
progressive loss in kidney function that will require
dialysis or transplantation. More than one-third of kidney
transplant patients in 2001 were between the ages of 20 and
44; many of them likely developed renal disease in
childhood, say doctors from the Children's Center.
The telltale signs of early kidney disease are
swelling (even mild) of the hands and feet and/or puffiness
around the eyes; decreased or increased frequency of
urination; long-lasting changes in the color and appearance
of urine; and headaches resulting from high blood
"If your child has any signs or symptoms that suggest
kidney disease, you should talk to your pediatrician and
obtain blood studies," Fivush said.
The best way to determine kidney function is to
measure glomerular filtration rate, which estimates the
speed at which kidneys filter waste material from the
blood. To determine GFR, doctors monitor blood levels of
the substance creatinine. The higher the creatinine level,
the higher the likelihood that the kidneys are not
filtering at normal speed. In addition to blood tests,
urinalysis can detect protein and/or blood in the urine,
also signs of kidney disease.
Systemic diseases such as diabetes or lupus put
children at higher risk for kidney damage.
Unrecognized kidney disease places people at greater
risk for high blood pressure, heart disease and stroke.
Researchers estimate that 650,000 Americans will develop
end-stage renal disease by 2010, costing the health care
system $28 billion a year. More than 11 percent of
Americans over the age of 20 (more than 19 million) have
some form of chronic kidney damage, according to recent
estimates by the National Institutes of Health. Each year,
about 5,000 children in the United States develop end-stage
kidney disease and require a transplant.