Your child will need to return to the hospital for follow-up appointments and tests. These will measure his or her kidney function (how well his or her kidneys are working) and check for any complications. Your doctor or nurse will also review any medicines that your child is taking. The doses or types of medicine may need to be changed, depending on your child’s needs and how he or she is responding to treatment. You will have an opportunity to ask any questions.

It is important to go to all appointments even if your child feels well. If you cannot go to an appointment, please speak with your child’s healthcare team to arrange another date.


At these appointments, your child will be assessed, including having his or her height and weight measured, to find out whether he or she is growing well.

Your child will also have blood pressure measurements – to check for hypertension (high blood pressure), or find out how well any treatment to control blood pressure is working.

Urine tests

Urine tests check for protein in the urine (proteinuria). You, or a nurse, will need to collect some of your child’s urine in a small, clean container. A dipstick will be dipped into the urine – this is a strip with chemical pads that change colour depending on what substances are in the urine. Your doctor or nurse will give you any special instructions, as you may need to collect your child’s first morning urine (the first urine he or she passes after waking) and/or do urine tests at home.

Blood tests

Your child will have regular blood tests.

These look for the following.

  • Urea – a waste product that the body makes from the food we eat. In CKD, this can build up in the blood stream, causing uraemia, which may cause children to feel tired and sick. If the levels of urea are very high, they may cause seizures (also called convulsions or fits).
  • Creatinine – another waste product, which is made from our muscles. This is tested to measure kidney function.
  • Parathyroid hormone (PTH) – the body makes this hormone to keep bones healthy. The PTH levels will be measured to find out whether your child is at risk of renal bone disease (renal osteodystrophy), when the bones become less strong.
  • Electrolytes are important chemicals in the body, which are also found in foods. We need the right balance of these to stay healthy. The kidneys help control the amounts of electrolytes. Some important electrolytes include the following:
  • sodium helps balance the amount of water in the body
  • potassium is needed for muscles, including the heart muscle, to work properly. Potassium levels may increase in CKD – this is called hyperkalaemia
  • bicarbonate balances the amount of acid in our body, or the pH balance (also called the acid–base balance). If there is not enough bicarbonate then the blood is acidic. This is called acidosis
  • phosphate is important for bones, teeth and muscles. Phosphate levels may increase in CKD – this is called hyperphosphataemia
  • calcium is important for bones and teeth, helps blood to clot, and also helps the muscles, including the heart muscle, to work. Calcium levels may decrease in CKD.
  • Tests for anaemia – children with CKD may develop anaemia because they have too few red blood cells or less haemoglobin, a substance that is in red blood cells. Because red blood cells and haemoglobin carry oxygen round the body, children often feel weak and tired and may look paler than usual. Blood tests check for the amount of iron and haemoglobin.
  • Fats (including cholesterol) – this test looks at types of lipids, which are fats, in the blood.

Specialised tests

Your child may need more specialised tests. Your child may need to be admitted to the ward at your paediatric renal unit for these (a specialised unit for babies, children and young people with kidney conditions, which may be in a different hospital to your own).

  • A more accurate test of kidney function, using a radioactive tracer. See Blood tests for more information.

More about measuring GFR in CKD – an introduction

  • Imaging tests (scans) – using special equipment to get pictures of the inside of his or her body, such as ultrasound scans to look at his or her kidneys, X-ray tests of the bones to see how your child is growing, and sometimes other tests that look at the kidneys and urinary system in more detail – such as a DMSA scan, MAG3 scan, MCUG or CT scan
  • Kidney biopsy – a tiny piece of one kidney is removed from the body with a needle, and examined under microscopes. Special medicines are used so your child does not feel any pain or can sleep through the procedure. A kidney biopsy can give more information about how much damage there is in your child’s kidney. It can take a few weeks to get the results.