AParent’s Guide to Kidney Disordersis one of a series of books designed to address the needs not only of parents but also of physicians and persons concerned with the care of children with relatively common disorders. We used as a modelThe Child with Down’s Syndrome, written by David W. Smith, M.D., and Ann Asper Wilson and first published in 1973 by W. B. Saunders, Philadelphia. The book is valuable because it makes the complex concepts of genetics and pediatrics understandable to parents. Such is the goal of our series.

InA Parent’s Guide to Kidney Disorders, the authors...

Parents of children with kidney disorders have much to gain from a clear understanding of how the kidneys function and what can go wrong with them. Better understanding often results in greater peace of mind for parents, because rather than worrying about the unknown, they can set realistic goals and expectations for their child. This knowledge also makes parents better able to teach their child as much about the disorder as possible.

It is natural for parents to be extra protective of a child with a chronic health disorder. Although each child’s health needs to be evaluated individually, in general...

We often hear patients and their family members say that doctors do too many tests. It is true that repeated physical examinations and laboratory tests can get to be a real drag. But it is important to remember that there are very good reasons for these procedures, and that they are done not justtothe patient, butforthe patient. Also, they provide answers to a question we often hear from the parents of our patients: “How can I be sure that my child doesn’t have a kidney disease?”

Although the signs and symptoms listed in Table 1 do...

Many of the diseases of the kidney discussed in this chapter are serious ones, often leading to significant and possibly permanent health problems. Certainly, having a child with such problems is of great concern to the family. However, the explosion of medical progress that has been made in the recognition and treatment of many of these diseases is very encouraging. We hope that some understanding of how a child develops a particular kidney problem, coupled with knowledge of the progress that has been made, will give parents reason to be realistic yet optimistic about their child’s future.

There are too...

Infection of the urinary system, or “urinary tract,” is one of the most common bacterial infections occurring in children. Urinary infections can become a significant medical problem if not treated promptly and adequately, and they can lead to serious complications. Most of the common infections of the urinary tract are caused by bacterial germs. When the infection is limited to the bladder, this is calledcystitis. A more serious infection involving the kidney is referred to aspyelonephritis.

These two types of infection differ not only in the symptoms they produce, but also in the potential long-term consequences they may...

As discussed in chapter 1, the kidney performs many different functions, including (1) removing the waste products produced by normal metabolism, (2) regulating the balance of water and minerals in response to the amount a person eats or drinks, (3) reclaiming important substances so that they may be reused by the body, and (4) producing certain hormones that affect such functions as blood pressure, bone structure, and production of red blood cells. Although there are diseases in which only one of these functions is abnormal, the term “kidney failure” is used when all of them, to one degree or another,...

Not too many years ago, permanent kidney failure inevitably led to death. Today, some form of dialysis or transplantation can be offered to virtually every child with kidney failure. However, there is still a great need for further progress in these fields. These are not simple treatments, and they require a great deal of time and expense, as well as patience on the part of the family.

Despite this, we have seen many children rise above their medical problems. With expert treatment, family support, perseverance, and a little good fortune, children with kidney failure can grow into active and productive...

This chapter provides a short outline of common types of dietary modifications that may be prescribed for people with kidney disorders. It was written with the assistance of Ann Abbott, R.D.

This information is intended only as an introduction to many of the diet-related terms you might hear from your physician or dietitian. Keep in mind that the type of diet prescribed often is individualized for each patient. The specifics will depend on the type of kidney disorder and the degree of kidney dysfunction. The diet of the patient in the earlier stages of kidney disease is frequently very different...

The stresses of chronic illness on both the patient and the family can be considerable. These stresses commonly affect self-image, peer and family relationships, school performance, and general quality of life. If medical care is to be complete, it therefore seems senseless to treat the medical illness without also treating the psychological impact of that illness on the patient and family. In order to broaden our perspective in this chapter, we have had the assistance of our pediatric nephrology social worker, Melissa Brown. Missy and her counterparts in other hospitals are very aware of the many nonmedical problems associated with...

Parents must deal with many potential problems when a child has a kidney disorder. Of these, the difficulties in managing medical therapy can be among the most troublesome. The doctors and other members of your health care team can give you valuable information about your child’s specific treatment program. Sometimes, however, it is only through trial and error that parents learn helpful hints, general rules of thumb, and basic drug facts. With the assistance of one of our pediatric nephrology nurse practitioners, Betsy Nicolli, we have gathered information about a variety of medication topics that we think will be of...

This chapter presents a potpourri of information. The subjects were selected after talking to many parents who told us what they wished they had known when they began coping with their child’s kidney disorder.

In the previous chapters, we presented information about the function of the kidneys, the disorders that may occur and how they are treated, and the psychological effects of disease on the child and family. This chapter will discuss some practical information from which parents might benefit. Having some knowledge of these subjects can ease the hospitalization process, assist in planning finances, and ensure that families take...

A great deal of promising research in kidney disease in children involves two different, but related areas—prevention and treatment. Prevention is by far the most ideal area in which to make progress, since the prevention of kidney disease would make treatment unnecessary. However, the concept of being able to prevent all kidney disease is, at the present time, unrealistic. Therefore, the discovery of new treatments must continue to be a priority for now.

Treatment can be considered to include both 1) the treatment of disease in the child’s own kidneys to minimize or stop the effects of the disease,...