Chronic Renal Failure
Chronic renal failure describes the condition where kidney function deteriorates over a period of time as a consequence of other disease processes, the most common of which in childhood are damage due to reflux of urine from the bladder (called vesico-ureteric reflux, described below) or inherited disorders such as polycystic kidney disease (in this section). The high levels of urea and creatinine are the cause of the symptoms of lethargy, nausea and itch, and result in a child who fails to thrive and grow. Unlike acute renal failure were there is a reduction in the production of urine, those with chronic renal failure may produce lots of urine (called polyuria) and as a result are very thirsty (called polydypsia). Besides failing to purify the blood and concentrate the urine, the damaged kidneys also fail to produce hormones such as Erythropoietin - so the child becomes anaemic - and vitamin D, so the child may develop Rickets (see the bone and joint section). As kidney function deteriorates further it can produce fluid overload and retention (oedema) in both the limbs and the lungs. Children with progressive renal failure need careful monitoring of their fluid and electrolyte balance. End stage renal failure requires dialysis and kidney transplantation.
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