Healthy kidneys process about 180 liters (or 60 gallons!) of blood each day to sift out waste and extra water, which are flushed from the body as urine. When the kidneys aren’t working as they should, it can have a significant impact on overall health and lead to the buildup of harmful toxins.
“Sometimes we know there’s an issue with the kidneys in utero or shortly after birth,” says Megan Lo, MD. “Other times protein or blood is identified in the urine, or kids have problems with urination that help lead us to a diagnosis.”
Conditions that can cause kidney impairment in kids include chronic kidney disease, nephrotic syndrome and congenital anomalies of the kidneys and urological structure or, more simply, being born with “bad kidneys.” In other cases, issues with the kidneys are associated with another condition, such as obesity, diabetes or hypertension.
Kidney care for kids
Our nephrology team helps kids with approaches ranging from diet modification and medication to dialysis and kidney transplant. Dietitian Christina Finotti works with children in all stages of this process to help ensure proper nutrition and fluid intake.
Many of the infants she sees are not able to take in the necessary calories, protein and fluid for their kidneys to function. For these little ones, who often require feeding tubes, formulas are blended to get just the right combination to meet their specific needs. With the older kids, she focuses on educating patients and families on the kidney-specific food restrictions they need to follow.
“Most kids with kidney conditions need diets low in sodium, potassium and phosphorus, so foods that we traditionally think of as healthy are not always the best options for them,” says Finotti. “At the same time, we still need to make sure they’re getting their vitamins and minerals for growth. Some kids may need to drink more than the average kid to stay well.”
She recommends the following guidelines for a kidney-friendly diet.
Limit high-potassium foods, such as:
Fresh peaches and pears
Fruit juices, particularly orange
Potatoes (all kinds)
Limit high-phosphorus foods, such as:
Cow’s milk (including milk, yogurt, ice cream and cheese)
Packaged foods with ingredients that say “phosphate”
Try lower-phosphorus options, such as:
Non-dairy milks including soy milk, almond milk or rice milk
Foods without “phosphate”
Helping patients thrive
Christina tracks growth closely, making nutrition recommendations accordingly. She may also provide multivitamin and Vitamin D supplements that have already been activated because poorly functioning kidneys cannot properly activate it in the body. This is in conjunction with other medications that are prescribed by the nephrologist, such as steroids to prevent or delay the loss of kidney function and/or immunosuppressant medications to make the body less likely to reject a new kidney in the case of a transplant.
Kidney conditions impact many aspects of children’s and families’ lives. Some children require catheters to flush urine from the body. Many come in for frequent clinic visits and lab draws. Dialysis can mean coming to clinic three days a week for approximately two to four hours each time
“We all work closely as a team to help our patients thrive. Whether that means managing their diet or guiding them through the transplant process, we’re on the child’s team the whole way.”
-Christina Finotti of her teammates, who include doctors, nurses, nurse educators, social workers and more
The pediatric nephrology team recently hosted their first Kidney Day, designed to bring patients and families from all walks of kidney disease and transplantation together to learn how to prepare kidney-friendly, healthy meals. The event gave patients an opportunity to find a sense of community and belonging with others kids just like them.
This expert kidney care has gained the attention of medical professionals nationwide. CHoR was named one of the nation’s best children’s hospitals again this year by U.S. News & World Report in the category of nephrology. The U.S. News Best Children’s Hospitals rankings are the result of a methodology that considers clinical outcomes, efficiency and coordination of care delivery, compliance with best practices and an annual survey of pediatric specialists. This is the fourth time CHoR has been ranked for kidney care.