Early stage CKD (one to three)
Most children do not have symptoms in the early stages of CKD.
Later stages of CKD (four to five)
If your child’s CKD progresses to the later stages, they are likely to develop more symptoms. Not every child will have all of these, but common symptoms include:
Changes in urinating (weeing)
Some children with CKD are unable to make concentrated urine (wee). This means they pass a large amount of weak urine. They often need to drink lots of water to make up for the water they are losing in their urine.
Other children with CKD are unable to make much urine. This means they pass only a small amount of urine.
Fluid overload
If your child’s kidneys are unable to make much urine, water and salts may build up in their body. This is called fluid overload. This may cause swelling (oedema) in their feet or hands, and puffiness around the face, especially in the morning.
Poor nutrition and growth, and low energy
Children may develop a poor appetite, and not be able to eat as much as they used to. They may also feel sick (nausea) or be sick (vomit) because of the effects of CKD or the medicines they need to take. They may also feel more tired than usual and have low levels of energy.
Renal bone disease
The kidneys are less able to control the levels of the minerals calcium and phosphate, and to activate vitamin D. These are all needed to keep bones and blood vessels healthy. Children may develop renal bone disease (renal osteodystrophy) where their bones become weaker and may not grow normally. Some children have no symptoms, but others have pain in their bones or joints, and are at risk of bone fractures.
Anaemia
Children may develop anaemia, a condition in which the blood has fewer red blood cells or less haemoglobin, a substance that is in red blood cells. Because red blood cells and haemoglobin carry oxygen around the body, children often feel weak and tired, and may look paler than usual.
Complications of CKD
In the later stages of CKD, children may be at risk of complications – health problems associated with their CKD. Your doctor will speak with you about how to reduce the risk of these complications. If your child follows the treatment plan, including any recommended changes to their diet and medicines they are less likely to have complications.
Diseases of the heart and circulation
There is a risk of developing cardiovascular disease (CVD) in later life, a group of diseases of the heart and circulation (blood going round the body). In children with CKD, this may be associated with:
- hypertension - high blood pressure. This can affect the heart, as well as speeding up the loss of kidney function.
- hyperkalaemia - too much potassium in the blood. In serious cases, this can affect the way the heart beats, which can cause a cardiac arrest, a life-threatening emergency in which the heart suddenly stops pumping blood. Many children with later stages of CKD need to follow a low potassium diet to avoid developing hyperkalaemia.