How can chronic kidney disease (CKD) affect children and their families? The lives of children with serious and long-lasting conditions such as CKD are affected in many ways. CKD is any condition that causes reduced kidney function over an extended period of time.

Children with CKD may have a negative self-image and may have relationship problems with family members due to the stress of living with a chronic disease. The condition can lead to behavior problems and make participating in school and extracurricular activities more difficult. CKD can cause learning problems because the buildup of wastes in the body can slow down nerve and brain function.

Children with CKD may have trouble concentrating and may develop language and motor skills more slowly than their peers. The most severe problems occur when CKD is present starting early in infancy. CKD that leads to kidney failure—described as end-stage kidney disease or ESRD when treated with a kidney transplant or blood-filtering treatments called dialysis—can increase these challenges. Fortunately, a kidney transplant can reverse or improve most of these problems. Dialysis can also improve or correct these problems. Most children with CKD who receive appropriate treatment can attend school, graduate from high school, and go on to college or vocational school.

However, families of children with CKD or kidney failure need to recognize that these children may need additional guidance and understanding. More information about kidney disease in children and its treatment is provided in the NIDDK health topics, and. How can parents and other adults help children with chronic kidney disease in daily life?

A Last Push for Obamacare Sign-ups — and Worries About Who Got Hurt. Blacks and Hispanics saw the biggest gains under the Affordable Care Act. Both hemodialysis and peritoneal dialysis are time-consuming and bring change to activities, diet and other aspects of daily life. In addition to medical services, the Pediatric Nephrology and Hypertension Program provides essential emotional support. A child-friendly environment, including televisions, games and other.

Parents and other adults can help children with CKD fit in at school, deal with low self-esteem, make friends, be physically active, and follow their treatment regimen. As children with CKD approach adulthood, they may need help with preparing to enter the workforce. Attending School School attendance is vital in helping children with CKD lead the best life possible. Many people are unaware of how CKD affects children. School administrators, teachers, and classmates should receive education and information about the effects of CKD. Children with kidney failure may miss school each week because of dialysis and medical appointments. These absences can compound the learning problems many children with CKD face.

Parents or guardians should make every effort to schedule treatments outside of school hours. The Individuals with Disabilities Education Act Public Law 94-142 states that every child is entitled to an appropriate education and directs school districts to provide special services to ensure children with disabilities can participate in regular classrooms to the fullest extent possible. Children with CKD may need • tutoring • vocational rehabilitation • special accommodations To receive special education services, children must be evaluated to see if they have a disability and must receive an Individualized Education Program—a written document that details the services each child will receive.

Parents or guardians of children with CKD should talk with the school counselor about having their child evaluated. Dealing with Low Self-esteem Having a chronic illness can make a child feel depressed and powerless. Learning and growth problems may also contribute to low self-esteem. One way to help children feel empowered is to give them as much control and responsibility over their own care as possible: • Children can learn more about their medications, including doses.

• Children on dialysis should be encouraged to take an active part in their treatments. • Parents or guardians should allow children to participate in treatment decision making. Urinary incontinence—the loss of bladder control, which results in the accidental loss of urine—is common in children with CKD. Urinary incontinence can be embarrassing for children and can make it harder to build relationships with their peers. However, several strategies and treatment options are available to help prevent urinary incontinence. More information is provided in the NIDDK health topic,. Making Friends Children with CKD may have trouble fitting in with children their own age because of their small stature or delayed mental development.

For children who have had a transplant, the side effects—such as a full face, weight gain, acne, or facial hair—of some of the medications they take may make it harder to make friends and may also lower self-esteem. Participating in regular classroom and extracurricular activities may help children improve their social skills. Summer camps and recreational programs for children with special needs can be a good place to make new friends.

Participating in Physical Activities and Sports Children with CKD should be encouraged to participate in physical activities, including exercise and sports. In general, exercise has physical and psychological benefits. Parents or guardians may feel protective of children with CKD; however, they should not try to limit activities unless instructed to by a health care provider. Some children may even need to be encouraged to get outside and play. Parents or guardians should talk with their child’s health care provider about the right activity level and appropriate sports for their child. Children who have had a kidney transplant can compete in sports. Every year the Transplant Games, sponsored by the National Kidney Foundation, allow people with transplants to participate in friendly competition and show the world that transplantation provides a new lease on life and health.

Following Treatment Regimens Children with CKD may need to take multiple medications, eat a specific diet, and follow their health care provider’s orders to help control their disease. Many children have a hard time following the treatment regimen. Health care providers use the term nonadherence to describe the failure or refusal to take prescribed medications or follow a health care provider’s directions. Adherence can be improved with a combination of health education, motivational techniques, and behavioral skill methods. Strategies need to be tailored to each child and the child’s family. The health care provider should • teach the child about the condition and treatment regimen • talk with the child to learn about the child’s wishes, beliefs, and feelings to find ways to improve motivation • suggest methods for remembering to take medications, such as a calendar, a pillbox, or text message reminders Preparing to Enter the Work Force Young adults who have been treated for CKD during childhood have to overcome a number of barriers to prepare for a career and find a job.

Completing the training required for employment takes more effort, and some people with CKD report that their small stature creates problems fitting into adult environments. Employers may have trouble understanding kidney problems and the accommodations that need to be made for people with CKD.

The employment section of the U.S. Royal Quiet Deluxe Serial Number Location. Department of Labor’s Disability website offers a variety of resources for employers and job seekers about career planning, workplace accommodations, work incentive programs, and other related issues. Who can help families deal with issues related to chronic kidney disease in children? Many skilled professionals are available to ensure that children with CKD get the best possible care. The family may want to talk with a social worker, mental health professional, financial counselor, and dietitian.

If a child reaches kidney failure, the medical staff at the dialysis center or transplantation clinic can provide help. Social Worker A social worker can help families locate services such as transportation and family counseling. The social worker can provide information about • finding support groups in the community • helping a child with a chronic illness rejoin school activities • reducing the stress of caring for a child with a chronic illness The social worker can also help families submit applications for Medicare and Medicaid. Medicare is a program that helps people older than 65 and people with disabilities, including people of any age with kidney failure, pay for medical care. Medicaid is a health care program for certain low-income individuals and families who fit into an eligibility group that is recognized by federal and state law.

Mental Health Professional A mental health professional, such as a psychologist, can help children with CKD find ways to deal with the emotional turmoil caused by having a chronic illness. Some child psychologists also specialize in helping children with disabilities and medical problems rejoin school activities. They may also be able to suggest techniques that reinforce adherence with taking medication and following the health care provider’s instructions.

Family members may also find that counseling helps them handle the conflicts and stresses they face. Many couples report increased tension in their marriage when their child has a serious illness such as CKD. Siblings may resent the amount of attention given to their sibling with CKD and feel guilty about having bad thoughts about their sibling. Financial Counselor A financial counselor can help families meet the financial obligations that chronic illness creates.

Medical bills can strain family finances; in some cases, a parent or guardian may need to stop working to care for a child full time. More information is provided in the NIDDK health topic,.

Dietitian Proper nutrition is extremely important for children with CKD. Every dialysis clinic has a dietitian to help people understand how the food they eat affects their health. The dietitian • helps develop meal plans to fit a child’s restricted diet • provides information about possible nutritional deficiencies caused by kidney disease • recommends special dietary supplements or formulas to improve the child’s nutrition • provides recipes and recommends cookbooks appropriate for people with kidney disease Following the restrictions of a kidney disease diet might be hard at first; however, making tasty and satisfying meals is possible with just a little creativity.

Eating, Diet, and Nutrition For children with CKD, learning about nutrition is vital because their diet can affect how well their kidneys work. Parents or guardians should always consult with their child’s health care team before making any dietary changes. Staying healthy with CKD requires paying close attention to the following elements of a diet: • Protein. Children with CKD should eat enough protein for growth while limiting high protein intake. Too much protein can put an extra burden on the kidneys and cause kidney function to decline faster. Protein needs increase when a child is on dialysis because the dialysis process removes protein from the child’s blood.

The health care team recommends the amount of protein needed for the child. Foods with protein include • eggs • milk • cheese • chicken • fish • red meats • beans • yogurt • cottage cheese • Sodium. The amount of sodium children need depends on the stage of their kidney disease, their age, and sometimes other factors. The health care team may recommend limiting or adding sodium and salt to the diet. Foods high in sodium include • canned foods • some frozen foods • most processed foods • some snack foods, such as chips and crackers • Potassium.

Potassium levels need to stay in the normal range for children with CKD, because too little or too much potassium can cause heart and muscle problems. Children may need to stay away from some fruits and vegetables or reduce the number of servings and portion sizes to make sure they do not take in too much potassium. The health care team recommends the amount of potassium a child needs. Low-potassium fruits and vegetables include • apples • cranberries • strawberries • blueberries • raspberries • pineapple • cabbage • boiled cauliflower • mustard greens • uncooked broccoli High-potassium fruits and vegetables include • oranges • melons • apricots • bananas • potatoes • tomatoes • sweet potatoes • cooked spinach • cooked broccoli • Phosphorus. Children with CKD need to control the level of phosphorus in their blood because too much phosphorus pulls calcium from the bones, making them weaker and more likely to break. Too much phosphorus also can cause itchy skin and red eyes. As CKD progresses, a child may need to take a phosphate binder with meals to lower the concentration of phosphorus in the blood.

Phosphorus is found in high-protein foods. Foods with low levels of phosphorus include • liquid nondairy creamer • green beans • popcorn • unprocessed meats from a butcher • lemon-lime soda • root beer • powdered iced tea and lemonade mixes • rice and corn cereals • egg whites • sorbet • Fluids. Early in CKD, a child’s damaged kidneys may produce either too much or too little urine, which can lead to swelling or dehydration. As CKD progresses, children may need to limit fluid intake. The health care provider will tell the child and parents or guardians the goal for fluid intake. More information is provided in the NIDDK health topics, and Kidney Failure:. Points to Remember • Children with chronic kidney disease (CKD) may have a negative self-image and may have relationship problems with family members due to the stress of living with a chronic disease.

The condition can lead to behavior problems and make participating in school and extracurricular activities more difficult. • CKD can cause learning problems because the buildup of wastes in the body can slow down nerve and brain function. Children with CKD may have trouble concentrating and may develop language and motor skills more slowly than their peers. • Parents and other adults can help children with CKD fit in at school, deal with low self-esteem, make friends, be physically active, and follow their treatment regimen. As children with CKD approach adulthood, they may need help with preparing to enter the workforce. • School attendance is vital in helping children with CKD lead the best life possible.

• One way to help children feel empowered is to give them as much control and responsibility over their own care as possible: • Children can learn more about their medications, including doses. • Children on dialysis should be encouraged to take an active part in their treatments. • Parents or guardians should allow children to participate in treatment decision making. • Participating in regular classroom and extracurricular activities may help children improve their social skills. Summer camps and recreational programs for children with special needs can be a good place to make new friends. • Parents or guardians may feel protective of children with CKD; however, they should not try to limit activities unless instructed to by a health care provider. • Children with CKD may need to take multiple medications, eat a specific diet, and follow their health care provider’s orders to help control their disease.

Many children have a hard time following the treatment regimen. Health care providers use the term nonadherence to describe the failure or refusal to take prescribed medications or follow a health care provider’s directions. • Adherence can be improved with a combination of health education, motivational techniques, and behavioral skill methods.

• Many skilled professionals are available to ensure that children with CKD get the best possible care. The family may want to talk with a social worker, mental health professional, financial counselor, and dietitian. If a child reaches kidney failure, the medical staff at the dialysis center or transplantation clinic can provide help. • For children with CKD, learning about nutrition is vital because their diet can affect how well their kidneys work. Parents or guardians should always consult with their child’s health care team before making any dietary changes.

Resources American Society of Transplantation (PDF, 312 KB) National Kidney Foundation Nemours KidsHealth Website Nephkids United Network for Organ Sharing (PDF, 1.67 MB) U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services (PDF, 743 KB) U.S. Social Security Administration (PDF, 413 KB) Clinical Trials The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions. What are clinical trials, and are they right for you? Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease.

Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses.. What clinical trials are open? Clinical trials that are currently open and are recruiting can be viewed. This information may contain content about medications and, when taken as prescribed, the conditions they treat. When prepared, this content included the most current information available. For updates or for questions about any medications, contact the U.S.

Food and Drug Administration toll-free at 1-888-INFO-FDA (1-888-463-6332) or visit. Consult your health care provider for more information. This content is provided as a service of the (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.

The NIDDK would like to thank: Barbara Fivush, M.D., and Kathy Jabs, M.D., of the American Society of Pediatric Nephrology (ASPN); Steve Alexander, M.D.; John Brandt, M.D.; Manju Chandra, M.D.; Ira Davis, M.D.; Joseph Flynn, M.D.; Ann Guillott, M.D.; Deborah Kees-Folts, M.D.; Tej Mattoo, M.D.; Alicia Neu, M.D.; William Primack, M.D.; and Steve Wassner, M.D., all on ASPN’s Clinical Affairs Committee; Frederick Kaskel, M.D., ASPN; Sharon Andreoli, M.D., ASPN.

Regie's Rainbow Adventure is a 7-week nutrition and physical activity program where you’ll follow Regie, the broccoli superhero, to different islands based on the colors of the rainbow. He meets new fruit and vegetable friends and earns his power stripes by eating healthy and being physically active. Each week children will travel with Regie to a new island, read a new story, try a new fruit or vegetable and bring healthy information home to their parents. It is a curriculum implemented by teachers in the classroom providing activities that reinforce literacy, language development, mathematic skills, scientific understanding, creative arts, social-emotional development, approaches to learning, and physical health & development through the series of seven interactive books, Regie's Rainbow Adventure. Through the Regie program, sites have seen: • Increased fruit and vegetable consumption by children who participate • Increased amount of physical activity by children who participate • Decreased daily screen time by children who participate Success Stories ”My child is more willing to try fruits and vegetables at home” -Parent ”My son learned to eat a lot of healthy fruits and vegetables in a fun way. My son likes to collect recipes and learned to know the vegetables and see them as something good.” -Parent ”I’m happy to see health brought to kids in a fun and easy way!” -Teacher 'It is delightful to see the children eat vegetables at lunch time now. They love broccoli and other veggies and talk about Regie Rainbow all the time.

They are more willing to taste new foods as a result of going on the adventures each week. It's a great program and we are so thankful that we have been able to take part in it.

Thank you very much!' –Site Leader 'We loved having Regie Rainbow in our class this year! Just got done with parent conferences and parents were telling us how much they loved it too. We are still talking about healthy eating in the classroom, hopefully we can make a lifelong impact on healthy eating with these children.' -Teacher Our new Regie’s Rainbow Adventure book is now available for purchase! Thank you to the team of awesome individuals who helped create this book, which details the history and importance of Regie being a part of the Early Childhood Development setting. You'll get an insider's view of how Regie was created, learn about the serious health issues in early childhood, and hear from the creative people who continue to develop Regie's story, his image and classroom activities.

You'll also visit a classroom with the team and see how the Regie program interacts with these young children. It's an exciting adventure and this unique book provides lots of ideas readers can use to consider bringing such a program to their communities. Check out the story of our book launch party!

The National Kidney Foundation of Michigan staff is available to provide a training for your early childhood staff to learn how to implement this program in their classroom. The program has been implemented in child care facilities including head starts, preschools, daycares, libraries, and public school classrooms. To learn more about this program, please contact: Crystal D’Agostino (734) 222-9800 x258 How You Can Get Involved: Teachers • Join the US Healthier School Challenge or Team Nutrition. • Encourage more physical activity during the school day, both inside and outside the classroom. • Talk to the children about healthy eating and why it is important for their bodies. • Start a school garden in which kids, parents, teachers, and community members can participate.

• Set a good example for the children by eating healthier and being more active. Parents • Encourage your children to make healthier food choices. Home Audiometer Hearing Test Crack. At every meal, half of a one’s plate should contain fruits and vegetables.

• Set limits on your child’s “screen time” and encourage more physical activity. • Start a school health team at your local school or with the PTA group. • Encourage your children to get involved in planning healthy meals by having them go shopping and cook with you. • Set a good example for the children by eating healthier and being more active. USDA My Plate- Encourages adults and children to build a healthy plate at every meal.

Child Care- Encourages child care providers to be more conscious about the nutrition and physical activity practices of the children they serve. Head Start Body Start- Promotes healthy lifestyles for both parents and their children through physical activity inside and outside the classroom.

Fruits and Veggies More Matters- Encourages adults and children to eat more fruits and vegetables by making it fun! Nourish Interactive- Includes resources for fun nutrition games for kids, interactive nutrition tools, and tips for parents and health educators to use to promote healthy living for the whole family. Great Start- A resource for finding information about early childhood events, providers, and resources in different areas.

Grow It, Try It, Like It- Preschool nutritional education curriculum that focuses on eating more fruits and vegetables. Nutrition Resrouces in Spanish- Tasty and Healthy Latin Recipes in Spanish- For more resources, including the Regie’s Rainbow Adventure™ Coloring Sheets and the Healthy Family Times Newsletters, vist the page.