Causes of Chronic Kidney Disease

The causes of kidney disease in children are different than in adults. The most common causes of kidney disease in children are:  

• Kidney birth defects 

• Genetic diseases 

• Kidney infection 

• Nephrotic syndrome 

• Systemic diseases 

• Kidney trauma or injury 

• Problems with the urinary system 

The most common causes of kidney failure differ based on your child's age: 

• From birth to age four, the most common causes are kidney birth defects and genetic diseases 

• From ages five to 14, the most common causes are genetic diseases, nephrotic syndrome and systemic diseases 

• From ages 15 to 19, the most common causes are problems with the glomeruli, such as nephrotic syndrome and lupus 

A genetic disease is passed down from one or both parents to your child through genes. Genes contain DNA and tell your cells what to do. You may also hear it called a hereditary or inherited disease. There is no way to prevent a genetic disease. There are medicines that can help treat and manage certain genetic diseases.

The most common genetic diseases that cause kidney disease are: 

• Alport syndrome 

• Polycystic kidney disease, either autosomal recessive polycystic kidney disease (ARPKD) or autosomal dominant polycystic kidney disease (ADPKD) 

• Nephropathic cystinosis 

Alport syndrome 

Alport syndrome is a rare genetic disease caused by mutations (changes) in three genes that tell certain parts of your child's body how to grow. As a result, parts of your child's kidneys, ears and eyes do not grow correctly. 

Alport syndrome always causes kidney disease and can also cause hearing loss and eye problems. Your child may start to have symptoms in early childhood. There are treatments that can help protect your child's kidneys and help them work well for longer.  

Autosomal recessive polycystic kidney disease (ARPKD) 

Autosomal recessive polycystic kidney disease (ARPKD) is one type of polycystic kidney disease (PKD). ARPKD is the less common type. It causes cysts to form in your child's kidneys and liver. Cysts are sacs filled with fluid. The cysts damage your child's kidneys' tissues and make them much larger than they should be. 

Babies may have symptoms before they are born that a doctor can see on an ultrasound. It can cause life-threatening problems in babies, such as kidney failure. Doctors treat the symptoms of ARPKD, such as with medicines. Doctors also treat any problems caused by ARPKD, such as urinary tract infections. 

Nephropathic cystinosis 

Nephropathic cystinosis is the most common type of cystinosis. Cystinosis is a rare genetic disease that causes cystine to build up in your child's cells. Cystine is a building block of protein. Too much cystine can damage their organs including their kidneys and eyes. 

Your child may start to have symptoms in early childhood. Doctors treat cystinosis with medicines, such as medicines to prevent cystine from building up. If untreated, it can lead to kidney failure.  

In kidney disease, birth defects are physical problems with your child's kidneys that they have since birth. The problems happen to your baby during pregnancy.

Common kidney birth defects include having: 

• Only one kidney instead of two (renal agenesis or solitary kidney) 

• Two kidneys, but one of them does not work well/at all (renal hypodysplasia) 

• A kidney that is in the wrong place, such as below, above or on the opposite side of the body compared to the usual place (ectopic kidney) 

• Bladder or ureter abnormalities (urine flow is blocked and/or urine flow goes in reverse and "refluxes" from the bladder to the kidneys) 

Doctors may not know why your child has a kidney birth defect. It may have been caused by a genetic disease or something that your baby was or was not exposed to during pregnancy, such as medicines the mother took while pregnant. 

Most children with a kidney birth defect will not have major health problems and can live full, healthy lives. However, children with a kidney birth defect may have a higher chance of kidney disease later in life. If your child has a kidney birth defect, talk to their doctor about how often they should be checked for signs of kidney disease. 

An infection happens when bacteria or a virus enters your child's body and causes an illness.  Many infections are treated with antibiotics and do not cause any long-lasting damage.  However, sometimes infections can lead to an inflammatory response that damages the kidneys, leading to: 

• Glomerulonephritis 

• Hemolytic uremic syndrome (HUS) 

• Interstitial nephritis 

Glomerulonephritis 

Glomerulonephritis attacks the tiny filters in your child's kidneys that clean their blood (glomeruli). You may also hear it called glomerular disease. When the glomeruli are damaged, they cannot remove waste and fluid from your child's body like they should. Your child may get glomerulonephritis suddenly or slowly in time. 

Causes of glomerulonephritis include: 

• Streptococci bacteria (the bacteria that causes strep throat) 

• Bacterial infection in your child's heart 

• Viral infections like HIV, hepatitis B and hepatitis C 

Hemolytic uremic syndrome (HUS) 

Hemolytic uremic syndrome (HUS) is a rare disease that happens when damaged red blood cells block your child's kidneys' filters. It can cause kidney damage and failure. 

Infection with E. coli bacteria is the most common cause of HUS. E. coli is a group of bacteria that is normally in your large intestine, but can cause infection when spread through contaminated food, such as meat and dairy. Doctors usually treat HUS in the hospital.  

HUS caused by E. coli is the leading cause of sudden kidney failure in children.  

Interstitial nephritis 

Interstitial nephritis is a disease that causes inflammation (swelling) around parts of your kidneys' filters called the tubules. This inflammation lowers your kidneys' ability to clean your blood and make urine (pee). There are two kinds of interstitial nephritis: 

• Acute interstitial nephritis, which lasts a short time. This is the most common type of interstitial nephritis.  

• Chronic interstitial nephritis, which lasts longer: weeks, months or years.