Teenagers and Chronic Kidney Disease

WI Staff | 3/19/2014, 2 p.m.
You never expect that kidney disease will happen to your child.

As a parent, you watch your teenager go through exciting and confusing times - from their involvement in school activities and getting their driver’s license, to choosing which college he or she wants to attend and dealing with loads of peer pressure. You never expect that kidney disease will happen to your child. So when your teenager learns he or she has chronic kidney disease (CKD), it can become an unexpected challenge in your family.

First things first: how do kidneys work?

Kidneys are responsible for removing waste and extra fluid from what you eat and drink from in the body. The nutrients you need remain in your body while the extra waste is filtered by the kidneys. Kidneys are made up of millions of tiny filters called nephrons which remove the unwanted fluids from the blood by creating urine. The urine travels down the ureters into the bladder and is stored until it is released through the urethra.

How do teenagers get kidney disease?

The two most frequent causes for adults to develop chronic kidney disease are high blood pressure and diabetes. In teens these causes are uncommon. However, due to unhealthy eating habits leading to excessive weight gain, more young people are prone to diseases such as diabetes and high blood pressure, which can cause kidney disease later in life.

For most teens, CKD is caused by congenital disorders or diseases that develop such as: Urinary problems, such as UTIs (urinary tract infection) and Reflux nephropathy.

Urinary tract infection (UTI)

The urinary tract consists of the urethra, the bladder, the ureters and the kidneys. Urinary tract infection (UTI) is caused when bacteria moves up into the bladder and multiplies. A bladder infection, or cystitis, is the most common UTI. Urinary tract infections are usually easy to diagnose in teens and adults.

Symptoms include: frequent, painful urination, inability to urinate despite the urge, urine that appears cloudy or has an unusual smell, blood in the urine, fever and flank or lower back pain if the kidneys are infected.

To diagnose a UTI, a urine sample is taken to check for the growth of bacteria. If the teenager is given antibiotics, relief usually begins within 12 to 24 hours of treatment. If the UTI affects the kidneys, intravenous medications may be necessary, requiring teens to be hospitalized.

After treatment, the doctor will collect another urine sample to determine if the medicine has gotten rid of the infection. Since UTIs tend to come back again, the doctor may want your teen to be tested on a regular basis.

Advice to prevent the recurrence of UTIs include:

After voiding, girls and women should wipe from front to back to prevent contaminating the urethra with bacteria from the anal area, Drinking plenty of water to flush the urinary tract, Not resisting the urge to urinate, Taking a shower instead of a bath

Reflux nephropathy

Reflux disorder is often diagnosed after a teenager has a UTI. It occurs when urine goes back up from the bladder to the kidney. This is due to a defect of the “valves” between the ureters and the bladder. Reflux can cause an infection to spread to the kidneys. This can be serious and may lead to kidney damage. About 30% of older children with UTIs will suffer from reflux disorder.

Sometimes surgery is done to correct reflux disorder, but most teens are treated with antibiotics. Teens diagnosed with reflux disorder usually recover after treatment. Typically, they do not have relapses. If kidney damage occurs, however, teens may get high blood pressure later in life. If one kidney is damaged, the risk of getting high blood pressure is 10%. If both kidneys have been injured, the risk rises to 20%. Most teenagers who experience reflux disorders do well and do not experience kidney damage.