Kidney problems 289

• Posterior urethral valve obstruction A narrowing or obstruction of the urethra

• Fetal hydronephrosis Dilatation or enlargement of one or both of the fetal kidneys due to a problem in the developing urinary tract

• Hydronephrosis Swelling of parts of the kidney that can occur in infancy or childhood due to a blocked urinary tract or vesicoureteral reflux (VUR), which is caused by a problem in the function of the mechanism that prevents urine from backing up from the bladder to the kidneys.

• Cystic kidney diseases These are usually present at birth. one type is polycystic kidney disease (PKD), in which many fluid-filled cysts in the kidneys take up most of the space in the kidneys, leading to kidney failure. Some forms of PKD are inherited. Multicystic kidney disease is another type of cystic kidney problem in which a developmentally abnormal kidney grows large cysts and eventually stops functioning. Although PKD always affects both kidneys, multicystic kidney disease frequently affects only one.

Diseases of the Kidney

While many kidney problems are present at birth, others do not appear until later in childhood. Some of these kidney diseases include:

• Renal tubular acidosis In this condition, the kidneys do not properly regulate the amount of acid in the body.

• Wilms' tumor A type of childhood cancer of the kidney

• Nephritis An inflammation or infection of the filtering unit of the kidney (nephron) that may be inherited or may be the result of an infection; more often, the cause is unknown.

• Nephrosis A change in the nephron that is not inflammatory

• Nephrotic syndrome This condition occurs when large amounts of protein are lost from the body through the urine.

• Infection Repeated kidney and urinary tract infections can cause kidney damage.

• Other diseases sickle-cell disease, lupus, high blood pressure, and diabetes also can cause kidney damage.

• Accidents A serious injury such a car accident or a major fall could potentially damage a child's kidneys.

• Kidney stones

Symptoms

The signs and symptoms of kidney disease can vary quite a bit from one child to the next. Children with chronic kidney failure may not have symptoms until 80 percent of their kidney function is lost. If symptoms do appear, they may include:

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