Barbara Fivush, M.D.

Nearly one in six Americans over the age of 20 has chronic kidney disease and many of them will go on to develop end-stage kidney disease, requiring dialysis and, ultimately, a kidney transplant. Most people with kidney disease will start developing their condition during childhood and adolescence, often silently and without symptoms.

March is kidney awareness month, and pediatric nephrologists at Johns Hopkins Children’s Center want to remind parents that timely detection of kidney problems in early childhood and adolescence is the best way to curb kidney damage and even reverse some of it.

These telltale signs of early kidney disease should prompt a visit to the doctor.

• Swelling (even mild) of the hands and feet and/or puffiness around the eyes
• Decreased or increased frequency of urination
• Long-lasting changes in the color and appearance of urine (foamy urine suggests the presence of protein)
• Headaches resulting from high blood pressure

“Kidney disease occurs more often than we think, but it is also more treatable than we used to think, especially when caught early,” says Barbara Fivush, M.D., director of pediatric nephrology at the Johns Hopkins Children’s Center. “Children and adolescents should be monitored carefully because kidney disease that seems to suddenly strike young adults often has its roots in childhood.”

The exact number of children with kidney disease in the United States remains unclear, while our understanding of pediatric kidney disease lags behind our knowledge of kidney disease in adults.

But pediatric nephrologists Hopkins Children’s are on the forefront of research to improve understanding of this stealthy killer. They are doing so by targeting different aspects of this complex condition, from genetics to quality of life to environmental factors that precipitate kidney disease.

“Kidney disease, especially pediatric kidney disease, is daunting and complex because of its many aspects and its many manifestations. It is really a constellation of diseases,” Fivush says. “We must tackle each one individually.”

Here are a few examples of the ongoing or latest research on kidney disease at Hopkins Children’s:

• Environmental exposures, kidney function and kidney disease
• Pediatric hypertension, kidney health, heart health
• Racial disparities and high blood pressure
• Quality of life in children with kidney disease
• Autoimmunity and pediatric kidney disease: Ongoing research of systemic lupus erythematosus (SLE), a common cause of kidney disease, and biomarkers of this often-evasive and hard-to-diagnose condition
• Vaccines and immunizations in children with kidney disease
• Kidney stones in children: Hopkins Children’s has one of the few pediatric stone clinics in the United States.
• Hopkins Children’s is one 16 centers involved in the largest-ever, ongoing study of kidney disease in children, known as the C-KID study, Chronic Kidney Disease in Children (C-KID) study.
• The genetics of kidney disease
• Anemia in children with kidney disease