“How is kidney failure handled in a child?”
My friend's son has congenital nephrotic syndrome and his kidney is on the verge of failing. Would he need to be on dialysis if his kidney fails? How is kidney failure treated in children?
6 Answers
Sorry, I am not a pediatric nephrologist. I am an adult nephrologist. Congenital nephrotic syndrome is a kidney condition that begins in infancy and typically leads to irreversible kidney failure. Treatment includes mediations to bring down protein in the urine and also diuretics for swelling. Again, please get the right answer from the right person (pediatric nephrologist).
The boy has good chances to recover kidney function if his mother takes him to a holistic medicine doctor.
That would be a conversation his parents need to have with his pediatric nephrologist.
This is so sad! Dialysis provides the removal of waste products so that he can continue to live until a transplant is possible, so yes he will likely need it.
Same as in adults.
There is not a simple and straight forward answer to your question. More details would be helpful. First and foremost: Dialysis is only a bridging therapy. Every child with end-stage chronic kidney disease should have a functioning kidney transplant. We sometimes are able to transplant the children without the need for dialysis, but this may be impossible in the case you are referring to.
In your note, it states that the child has congenital nephrotic syndrome. These children typically require the surgical removal of both kidneys prior to transplantation and several weeks of dialysis. The reason is that due to the losses of protein in the urine the entire blood proteins are deranged and this is associated with a high risk for clotting the transplant. It may take 1-2 months before the protein levels in the blood are restored.
There is a choice between two types of dialysis: hemodialysis and peritoneal dialysis. The former is typically done in centre and requires frequent visits to the hospital. You need to have access to clean the blood, for instance, through a central venous line, or an arteriovenous fistula. Peritoneal dialysis in children can be done at home. As most children have a very fast transport of solutes through the lining of the abdomen, they can typically dialyze with a machine overnight for perhaps 8-10 hours using physiological solutions such as Physioneal. This treatment is not painful, does not require accessing the blood system, and allows to go to school. Peritoneal dialysis is the preferred form of dialysis in children, but not every child can do it and it is demanding on the parents.
Best regards,
Guido Filler, MD, PhD, FRCPC
In your note, it states that the child has congenital nephrotic syndrome. These children typically require the surgical removal of both kidneys prior to transplantation and several weeks of dialysis. The reason is that due to the losses of protein in the urine the entire blood proteins are deranged and this is associated with a high risk for clotting the transplant. It may take 1-2 months before the protein levels in the blood are restored.
There is a choice between two types of dialysis: hemodialysis and peritoneal dialysis. The former is typically done in centre and requires frequent visits to the hospital. You need to have access to clean the blood, for instance, through a central venous line, or an arteriovenous fistula. Peritoneal dialysis in children can be done at home. As most children have a very fast transport of solutes through the lining of the abdomen, they can typically dialyze with a machine overnight for perhaps 8-10 hours using physiological solutions such as Physioneal. This treatment is not painful, does not require accessing the blood system, and allows to go to school. Peritoneal dialysis is the preferred form of dialysis in children, but not every child can do it and it is demanding on the parents.
Best regards,
Guido Filler, MD, PhD, FRCPC
