Health Tip Category: Urology

High blood pressure is common in children with chronic kidney disease (CKD). Because of their young age when they develop CKD and high blood pressure, there is a high risk that these children may eventually have heart problems and a worsening of CKD. It is very important for children with CKD to be checked for high blood pressure. Early detection and treatment of high blood pressure helps to reduce the chance of these complications. This fact sheet is written for parents of children with CKD. The booklet will tell you what you need to know about detection and treatment of high blood pressure in your child.

What is chronic kidney disease?
Chronic kidney disease means that the kidneys have been damaged by diseases such as the ones listed in the next question. As a result, the kidneys are less able to do the following jobs to help maintain health:

• Remove wastes and extra fluid from the body

Release hormones that:

• Control blood pressure
• Prevent anemia (low blood count)
• Promote strong bones
• Make hormones that promote normal growth and development in children
• Keep the right balance of important chemicals in the blood, such as sodium, potassium, phosphorus and calcium.
• Maintain the body’s balance of acids and bases.

What is high blood pressure?
Blood pressure is the force of your blood against the walls of your blood vessels as the heart pumps blood around the body. If this pressure becomes too high, someone is said to have high blood pressure, or hypertension.

What causes high blood pressure in children?
As in adults, high blood pressure is more common in children who:

• Are overweight
• Are African American
• Have a family history of high blood pressure
• Have CKD.

When a child has high blood pressure, the doctor should check for kidney diseases (such as the ones listed earlier) as a possible cause of high blood pressure.

How are high blood pressure and CKD-related? High blood pressure is a leading cause of CKD in adults and contributes to the worsening of CKD in children. High blood pressure can also be a complication of kidney disease. The kidneys play a key role in keeping blood pressure in a healthy range. If your child’s kidneys are damaged, they are less able to help regulate blood pressure. As a result, the child’s blood pressure increases and CKD gets worse. Making sure your child’s treatment plan is followed carefully and his/her blood pressure is controlled can help keep kidney disease from getting worse and prevent heart disease.

What are cystine stones?
A cystine stone is a type of kidney stone. Many people think there is only one type of kidney stone. But in fact, there are different types. A kidney stone is a solid piece of material that forms in a kidney. It may stay in the kidney or travel down the urinary tract.

Cystine stones tend to reoccur and are typically larger than other kidney stones. You should talk to your healthcare provider if you get cystine stones. There are things you can do to lessen your risk of forming new stones. You may not know you have a cystine stone. It is important to have stones diagnosed to help get the right treatment for this condition.

Causes
Cystine stones are caused by a rare disorder called “cystinuria.” The disorder causes a natural substance called “cystine” to leak into your urine. When there is too much cystine in the urine, kidney stones can form. These stones can get stuck in the kidneys, bladder, or anywhere in the urinary tract. Most people with cystinuria have recurring stones. It is a lifelong condition that can be controlled, but not cured.

Who is at risk for cystinuria?
Cystinuria is an inherited disorder. Inherited means it is passed down from parents to children through a defect in a specific gene. In order to have cystinuria, a person must inherit the gene from both parents. About 1 in 7,000 people worldwide have cystinuria. According to a recent study, most people with cystinuria get their first stones in their twenties or thirties with 30-40% of people developing cystine stones in their teens. But some adults have their first cystine stone after age 40. Children can also get cystine stones. In fact, according to some research, 8-10% of kidney stones in children are cystine stones.