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A Guide to the Management of Childhood Nephritis

 
Cartoon of family (Illustration by Jan Smith)

INTRODUCTION

Nephritis is a condition that affects the kidneys. It requires special attention. Most children with nephritis make a full recovery within a few weeks.

This leaflet has been prepared to help children and their families understand what happens to a child who has nephritis.

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WHAT IS NEPHRITIS?

Nephritis is a name given to inflammation of the kidneys. It is usually a reaction to a recent simple infection, such as a sore throat. Kidneys with nephritis don’t work as well as they should. When kidneys are severely affected we call this acute kidney injury or ‘acute renal failure’. Almost always the kidneys recover completely.

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WHAT DO THE KIDNEYS DO?

The kidneys are responsible for processing water and the body’s waste products. Urine is produced by the kidneys and consists of water and waste products. The kidneys also help in controlling blood pressure and the prevention of anaemia.

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WHAT ARE THE SIGNS OF NEPHRITIS?

If the kidneys don’t make enough urine then the body has more fluid than it needs. This can cause the body to get puffy or swollen (we call this oedema). The swelling usually appears around the eyes first. It can also appear around the ankles.

Inflammation in the kidney can cause blood to appear in the urine. This makes the urine red and brownish in colour. The amount of urine passed is often reduced.

Your child’s blood pressure may be high.

Your child may feel generally unwell because of these things. They may lack energy and be off their food. Occasionally children with nephritis complain of headaches and stomach pains.

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WHAT TESTS WILL MY CHILD NEED?

When your child first develops nephritis they will need some blood and urine tests. These are done to see how well the kidneys are working and to look for the cause of the kidney inflammation. Over the first few days they will need further blood tests to monitor their progress.

We will need to monitor how much urine is passed during the day, and how much your child drinks.

Usually the tests and monitoring are carried out in hospital. Only if your child has unusual features for their nephritis will we consider a renal biopsy. The kidney specialist will discuss this with you and give you more information.

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WHAT IS THE TREATMENT?

If the kidney inflammation has occurred after an infection then a course of antibiotics will be given.

The amount of fluid your child drinks may need to be restricted.

If your child has high blood pressure this may need treatment with medicines.

A healthy eating diet is recommended which all the family can follow. It is important that your child doesn’t add salt to their food at the table and also avoids salty snacks such as crisps and soup. You may be advised to reduce your child’s intake of a salt called potassium. There is a lot of potassium in bananas and fruit juice. Some children require changes in their diet to increase their calorie (energy) intake while they are unwell. A dietician will visit you to offer advice.

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Will my Child get Better?

Most children with nephritis make a full recovery within a few weeks, although it is not uncommon to find some blood in the urine for several months afterwards.

After discharge from hospital your child will often be encouraged to return to school quickly. Progress will be monitored in the clinic until they are sure the kidney inflammation has healed completely.

When your child is well they can return to enjoying all their usual activities.

Occasionally the nephritis does not go away but becomes a chronic condition. In this situation your child may also need a kidney biopsy to diagnose the type of nephritis before we consider further treatment.

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WILL THE NEPHRITIS COME BACK?

Sometimes another sore throat or infection can cause the reappearance of blood in the urine but unless there are other signs of nephritis such as swelling, your child will not need to be readmitted.

If you are worried you should contact your GP or the children’s renal unit.

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The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.

NKF Controlled Document No. 105: A Guide to the Management of Childhood Nephritis written: 15/04/2007 last reviewed: 14/11/2020