Pediatric Nephrology in New Jersey

Compassionate Kidney Services for Infants, Children and Adolescents

children smiling in a group

Kidney disease can occur at any age, even in the youngest of individuals. At RWJBarnabas Health, our healthcare professionals understand the kind of care and vigilance that children need as they struggle with serious kidney conditions. These conditions can affect their well-being, interfere with their growth and development, and may even necessitate a kidney transplant for optimal healing.

Our pediatric nephrologists and medical staff are compassionate professionals accustomed to educating families about kidney disease. We will help you learn about your child’s condition and treatments. We can help you find practical coping methods and helpful tips for day-to-day life. We encourage you to ask questions of your doctors and nurses, and never to be afraid to voice your concerns along the way. We are here for you.

About Our Pediatric Kidney Care Services

Our pediatric nephrology program serves families whose children have kidney and hypertensive disorders (high blood pressure). We also provide comprehensive prenatal counseling for expectant mothers and families. Our skilled professionals can help test for genetic diseases and fetal renal anomalies while a child is still in utero and, if needed, recommend and provide treatment.

We consistently exceed the national average for kidney transplant success. Our pediatric nephrology team includes dedicated, accomplished kidney surgeons and specialists who have performed more kidney transplants than any other healthcare facility in the state of New Jersey. We regularly work with families where parents are prepared to donate a kidney to their child and provide state-of-the-art care throughout every stage of the transplant process.

Kidney Conditions We Treat

Your child may be referred to our nephrology if they experience:

What Is the Role of the Kidneys?

Kidneys are two bean-shaped, fist-sized organs located below the rib cage on either side of the spine. They are responsible for producing urine that removes waste and other fluids from the body. The kidneys work 24/7 and maintain a proper balance of water, salts, and minerals in the body while filtering the blood. The kidneys also have complex relationships with other organs to produce hormones to stimulate red blood cells production, which helps regulate blood pressure. When the kidneys fail to function as they should, the body fills with excess water and waste products and each organ system begins to shut down one by one, making it a dire medical emergency to treat early.

What Causes Kidney Disease in Children?

Kidney disease takes many forms in children. It may be a treatable, fleeting condition, or it may be something that is chronic, progressive, and life-threatening. The cause of kidney disease depends on whether it is acute or chronic in nature. Acute kidney injury has a sudden onset, is short in duration, and may either be serious with long-lasting consequences or can be cured once the underlying cause is treated. By contrast, chronic kidney disease (CKD) is life-long and tends to progress to kidney failure and eventually must be treated either with a blood-filtering treatment called dialysis or a kidney transplant.

Acute kidney disease may be caused by:

  • Dehydration
  • Medications
  • Nephritis (inflammation in the kidneys)
  • Blood loss
  • Shock
  • Blockages in the urinary tract
  • Cardiac arrest
  • Infections

Chronic kidney disease is typically the result of a birth defect or hereditary disease such as polycystic kidney disease or Alport syndrome, but it may also be caused by:

  • Physical trauma
  • Lupus
  • Diabetes
  • A systemic infection

Pediatric Kidney Disease Symptoms

The symptoms of kidney disease, even in adults, often go unnoticed until end-stage renal (kidney) failure. In fact, children are at an even higher risk of this because of the vague nature of the symptoms. In addition to this, many children are unaware of the changes impacting their bodies and do not tell their parents about their symptoms, so their parents are just as unaware.

Parents who have a genetic history of kidney disease should be vigilant in checking their children for potential signs of pediatric kidney disease.

Genetic-related disease is much more common among young people than it is in adults – for example, some children whose mothers who had decreased amniotic fluid may be diagnosed with polycystic kidney disease.

Some of the common symptoms of kidney disease among children, when present, may include:

  • Swelling of the hands or feet
  • Nausea and vomiting
  • Fatigue
  • Indentations on the skin, such as from socks or a belt
  • Loss of appetite
  • Changes in urination frequency
  • Sudden occurrence of bedwetting
  • Long-lasting changes in urine color, blood in urine, or foamy urine
  • Headaches resulting from high blood pressure
  • Flu-like symptoms (nausea, vomiting, fatigue, weakness)
  • Slow growth and development, short stature
  • Difficulty concentrating
  • Learning disabilities

Pediatric Kidney Disease Diagnosis

Your child’s pediatrician will ask for a complete medical history and review their signs and symptoms before conducting a complete physical exam. If kidney disease is suspected, follow-up tests may be ordered, such as blood, urine or imaging tests.

The following tests may confirm the diagnosis of pediatric kidney disease:

  • Dipstick test for albumin (protein). This lab test checks for the presence of albumin in the child’s urine, which could indicate kidney damage.
  • Blood test. Blood drawn for analysis can estimate how the kidneys filter the blood each minute.
  • Imaging tests. Pictures of the kidneys can help physicians see these organs and identify size and shape abnormalities.
  • Biopsy. A kidney biopsy involves taking a small piece of kidney tissue to examine under a microscope to determine whether kidney disease is present and its extent.

Treatment of Pediatric Kidney Disease

There is no one-size-fits-all pediatric kidney disease treatment. Your child’s pediatric nephrologist, or a medical specialist in the treatment of kidney disease in children, will devise a treatment plan depending on the type of kidney disease your child has. Treatments include may include medication, diet modification, dialysis, or a kidney transplant.

Medication to Lower Blood Pressure Can Ease Stress on the Kidneys

If your child has kidney disease that causes hypertension (high blood pressure), your child’s pediatric nephrologist may prescribe medication to lower their blood pressure. This can slow the progression of chronic kidney disease and relax the blood vessels so the heart can pump blood more easily, or diuretic medication to increase urine output. Many children are prescribed multiple medications for blood pressure control. If they have chronic kidney disease, they might need additional medication for anemia treatment and growth failure.

Nutrition Management Can Help Maintain Balance

Many children with chronic kidney disease must eat a special diet to stay as healthy as possible. This can be quite challenging to manage, so a registered dietitian will work with you and your child to regulate their diet and keep it in check. For example, you child must eat enough protein for proper growth and development, but they must not each too much protein as it puts too much of a burden on the kidneys and makes them decline more quickly.

Sodium intake must be limited, as well, as the kidneys cannot properly filter salts as they should.

Potassium should be regulated so as to avoid heart or muscle problems, and phosphorus should be controlled to protect the bones.

Fluid intake should be monitored to protect against swelling or dehydration.

Dialysis Is Used to Filter Blood in Place of the Kidneys

Dialysis is the process of filtering wastes and extra fluid from the body by means other than the kidneys. Dialysis may be necessary if a child is in late-stage kidney failure. Most children with low kidney function will need this treatment to sustain life and replace the function of a failing pair of kidneys, especially if a kidney donation is not available at the time of kidney failure.

Your child’s pediatric nephrologist will discuss your child’s options early on to prepare you for either dialysis or a kidney transplant so you know what to expect. Dialysis is typically done with a machine in a center 3 or 4 times a week and takes several hours to perform.

Pediatric Kidney Transplant

Children with chronic kidney disease often progress to end-stage renal failure, where both kidneys no longer function adequately. Although dialysis is a suitable treatment to filter the blood and remove waste products from the body in the short-term, a pediatric kidney transplant is a much more preferable option for most patients and improves patient quality of life and can extend life for many children with chronic kidney disease.

Children can receive a kidney either from a live or deceased donor, given they pass strict eligibility and compatibility criteria with the intended recipient. Some children are able to bypass the need for dialysis completely and receive what is called a preemptive kidney transplant.

How Chronic Kidney Disease Can Impact Children’s Lives

Children with kidney disease often face many difficulties in life and must learn positive coping mechanisms to handle living with their illness. Many experience urinary incontinence, which can lead to a negative self-image and make participating in certain activities more challenging. Other effects may include:

  • Behavior problems
  • Learning disabilities
  • Difficulty concentrating
  • Delayed language development
  • Delayed motor skills development

Fortunately, children whose kidney disease can be successfully treated or reversed have better odds of improving the challenges that impact their lives. Dialysis may also improve the problems in their lives.

Most children with chronic kidney disease can and do graduate from high school and go on to lead normal lives. These children do, however, need understanding families who are willing to provide additional guidance or understanding through challenging times.

Learn more tips for parents of children with chronic kidney disease from the National Kidney Foundation.

Patient Stories

  • Everyone at CSH made me feel like my opinions and concerns were being heard, they explained every step and gave us lessons to apply at home.

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  • It was hard being in the hospital for so long, but we were grateful that CSH allowed parents to stay. The hospital had a family lounge, game nights, and lots of ways to keep the parents informed. We had weekly meetings with his care team and received daily ...

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  • "Tyler and Sam do an excellent job at stepping back and seeing the whole picture and providing thorough information for us to assist Elias, and that's huge. That's what everybody needs and deserves, and their children deserve when going to services, and ...

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