The treatment depends on the stage and the symptoms that your child has.
Where is my child treated?
Mild or early CKD: stages 1 to 3a
In early stages of CKD, your child will probably be monitored by a paediatrician, a doctor who looks after babies, children and young people with different health conditions. Your paediatrician may be in your local hospital or another setting in your area, such as a community clinic.
In very mild cases, your child may be monitored by your family doctor, or general practitioner (GP).
You will be given advice on how your child can live healthily to protect his or her kidneys. Some children need to take medicines to help control their blood pressure.
Late CKD: stages 3b to 5
Those children who reach later stages of CKD need more specialist treatment. They are normally referred to a paediatric renal unit, a specialised unit for babies, children and young people with kidney conditions, which may be in a different hospital to your own.
You will be introduced to a team of healthcare professionals who will support your child and family, particularly in the later stages of CKD. The team may include a:
- paediatric nephrologist – a doctor who treats babies, children and young people with kidney problems
- renal nurse – a nurse who cares for babies, children and young people with kidney problems
- paediatric dietitian – a professional who advises what your child should eat and drink during different stages of a kidney condition
- renal social worker – a professional who supports you and your family, especially with any concerns about money, travel and housing related to looking after your child with kidney disease
- renal psychologist – a healthcare professional who supports your child and family, especially with emotional stresses and strains from having or looking after a child with kidney disease
- play specialist – a professional who uses dolls and other toys to help your child prepare for procedures, such as blood tests and dialysis.
Depending on your child’s health, some of the clinic appointments and monitoring can still be done partly by your local paediatrician working closely with the paediatric renal unit.
About treatment: stages 1 to 3a
Most children do not need any treatment in the early stages of CKD.
Controlling blood pressure
It is important that your child’s blood pressure is controlled so it is in the healthy range. Even at early stages, children are at risk of hypertension (high blood pressure), which can also cause further damage to their kidneys and may speed up progression to later stages of CKD. Your child may need to eat a no-added salt diet and/or take medicines.
Reducing protein loss in urine
If your child has a high level of protein in his or her urine (proteinuria) he or she may need to take a medicine to reduce the amount of protein in his or her urine. This is usually a medicine called an angiotensin-converting enzyme inhibitor (ACE inhibitor) or angiotensin-II reception blocker (ARB).
Research suggests that, in some children, these medicines will reduce the risk of long-term kidney problems.
It is important that you follow your doctor’s instructions about when and how much to give. Do not stop the medicine suddenly.
Living healthily
Your child can help protect his or her kidneys by leading a healthy lifestyle. This includes:
- eating a healthy diet – with at least five servings of fruit and vegetables a day, taking care not to eat too much salt, sugar and fats (especially saturated fats)
- getting plenty of exercise
- not smoking
- not taking the medicines ibuprofen or diclofenac as they could further damage his or her kidneys.
About treatment: stages 3b to 5
Those children who reach later stages of CKD have more symptoms that are associated with the worsening kidney function. They will need treatment to manage the symptoms.
Eating and drinking
As the kidneys work less well, they are less able to control the amount of water, salts and nutrients in the body. Children often need to make changes to how much they drink and what they eat. Some children and babies develop a poor appetite and may feel sick (nausea) or be sick (vomit). They can be fed through a tube to make sure they have the nutrition they need to grow.
Feeding your baby or child with CKD
Medicines
Children will need to take medicines to treat symptoms and/or to try to slow down the progression to kidney failure. Often, the types or doses (amounts) of medicines change as children progress through these stages.
About treatment: kidney failure
In stage 5, when the kidneys are in failure, children usually need specialist treatment, such as dialysis and/or a kidney transplant. Children start preparing for one or both of these treatments in stage 4. Plans are made so that, if at all possible, children have a kidney transplant in time to avoid having to start dialysis.