Kidney Failure in Teens: Symptoms, Causes, and Treatment

The idea of kidney failure can sound scary, especially if you or someone you care about has just been diagnosed. This guide is written for teens and their families to explain, in clear language, what kidney failure is, what signs to look for, how doctors treat it, and how you can still build a full, meaningful life while managing kidney disease.

What Your Kidneys Do and Why They Matter

You have two kidneys, each about the size of a fist, located near the middle of your back, just below your rib cage. They are powerful filters that work all day, every day, to keep your body in balance.

Healthy kidneys:

• Remove waste and extra water from your blood, turning them into urine.
• Balance minerals (like sodium, potassium, calcium, and phosphorus) so cells, muscles, and nerves can work properly.
• Control blood pressure by managing fluid and certain hormones.
• Help make red blood cells by releasing a hormone called erythropoietin, which signals bone marrow to produce these cells.
• Keep bones strong by helping your body use vitamin D and manage calcium and phosphorus levels.

When kidneys become badly damaged, they can no longer do these jobs well, and many parts of the body are affected.

What Does Kidney Failure Mean?

Doctors use the term kidney failure (also called end-stage kidney disease or end-stage renal disease) when the kidneys have lost almost all their ability to work on their own.

Two main patterns of serious kidney damage can lead to failure:

• Acute kidney injury (AKI): Kidney function drops suddenly, over hours or days. This can happen after a severe infection, major blood loss, serious dehydration, certain medicines, or a major injury.
• Chronic kidney disease (CKD): Kidney damage slowly worsens over months or years. Over time, CKD can progress to kidney failure if not treated.

In teens, long-term kidney problems are often related to birth defects, inherited conditions, infections, or problems with the urinary tract rather than the typical adult causes like long-standing diabetes or high blood pressure.

Early Signs and Symptoms in Teens

One of the trickiest things about kidney disease is that early stages can be almost silent. Many kids and teens feel fine at first and only find out there is a problem through blood or urine tests done for another reason.

As kidney damage gets worse, you may notice symptoms such as:

• Changes in urination: Peeing more or less than usual, getting up often at night, bedwetting after being dry, or foamy urine (sign of protein).
• Swelling (puffiness) in the face, around the eyes, hands, legs, or feet from fluid your kidneys cannot remove well.
• Tiredness and weakness from anemia (too few red blood cells) or waste building up in the blood.
• Loss of appetite, nausea, or vomiting that does not seem to be from a short-term illness.
• Headaches or trouble concentrating, sometimes related to high blood pressure or changes in blood chemistry.
• Shortness of breath from fluid buildup or anemia.
• Dry, itchy skin caused by mineral and waste buildup.
• Slow growth or being much smaller than peers, especially in younger teens and children.

Symptoms can be different from person to person. Some teens have mostly tiredness and low appetite, while others notice swelling or bathroom changes first.

Why Do Teens Get Kidney Failure?

Many different problems can hurt the kidneys. In teens and children, the most common causes include:

• Birth defects (congenital problems) – Kidneys or urinary tracts that did not develop normally before birth, such as kidneys that are too small or have blocked drainage.
• Genetic (inherited) diseases – Conditions passed down from parents, like polycystic kidney disease, Alport syndrome, or other rare inherited disorders.
• Glomerular diseases – Illnesses that damage the tiny filters in the kidneys (glomeruli), including some forms of glomerulonephritis or nephrotic syndrome.
• Reflux and blockages – Urine flowing backward from the bladder toward the kidneys (vesicoureteral reflux) or long-term blockages (for example, from structural problems or stones) that strain the kidneys.
• Infections or immune diseases – Severe kidney infections or autoimmune diseases such as lupus that cause inflammation and scarring over time.
• Systemic conditions – In some older teens, poorly controlled diabetes or high blood pressure can damage kidneys, similar to adults.
• Medications and toxins – Certain drugs (like some pain relievers, antibiotics, or illegal substances) and heavy dehydration can injure the kidneys, especially in high doses or over long periods.

How Doctors Diagnose Kidney Problems

If a doctor suspects kidney disease, they will usually start with simple tests and add more detailed exams as needed.

These tests help doctors decide how serious the kidney damage is and which treatments are most likely to help.

Treatment Options: Protecting and Replacing Kidney Function

Treatment depends on how damaged the kidneys are and what is causing the problem. Some conditions can be reversed or improved; others slowly progress and may eventually require dialysis or a transplant.

Slowing Down Chronic Kidney Disease

When kidneys are damaged but still working, doctors focus on protecting the function that remains.

• Treating the cause — For example, controlling high blood pressure, treating infections, or managing autoimmune disease with medicines.
• Blood pressure control — Often with ACE inhibitors or ARBs, which can protect the kidneys as well as lower blood pressure.
• Diet changes — A kidney-friendly eating plan may limit sodium, certain minerals, or total protein; a dietitian usually helps design this.
• Managing anemia and bone health — Medicines and supplements may be used to help red blood cell levels, vitamin D, calcium, and phosphorus.
• Avoiding kidney-harming drugs — Doctors may recommend staying away from some pain relievers or other medicines that can hurt the kidneys, especially when dehydrated.

Dialysis: When Kidneys Need Backup

Dialysis is a treatment that uses a machine or a special fluid in the belly to remove waste and extra fluid when the kidneys can’t do it well enough. It does not cure kidney failure, but it can keep you healthy while waiting for a transplant or when transplant is not an option.

Two main types are used in teens:

• Hemodialysis
  Blood is pumped through a machine that cleans it and then returns it to your body. Treatments are usually done several times a week at a dialysis center, though some people can do it at home after training.
• Peritoneal dialysis
  A soft tube (catheter) in the abdomen is used to fill the belly with a special fluid that absorbs waste. The fluid is then drained and replaced. This can often be done at home, including overnight while you sleep.

The medical team will talk with you and your family about which type of dialysis best fits your health, lifestyle, and daily routine.

Kidney Transplant

A kidney transplant is surgery to place a healthy kidney from a donor into someone whose own kidneys have failed. Many children and teens with kidney failure are able to receive a transplant, often from a deceased donor or sometimes from a living relative or another volunteer donor.

After transplant:

• You still keep your own kidneys unless there is a reason to remove them.
• You must take medicines every day to prevent your body from rejecting the new kidney.
• You will have regular follow-up visits and blood tests to make sure the kidney is working well.

A successful transplant can give you more energy, more freedom with food and fluids, and fewer day-to-day treatment sessions than dialysis, but it also requires lifelong medical follow-up.

Everyday Life With Kidney Disease

Living with kidney disease or kidney failure means adjusting to new routines, but it does not have to stop you from going to school, spending time with friends, or planning your future.

School, Sports, and Activities

• School: Most teens continue regular classes. Some may need flexible schedules for dialysis or medical visits. A school counselor or nurse can help set up accommodations.
• Physical activity: Many people can stay active with their doctor’s guidance. You may need to avoid full-contact sports after a transplant or with certain types of catheters.
• Sleep and rest: Tiredness is common. Planning consistent sleep and short rest times can help you keep up with daily tasks.

Food, Drinks, and Medicines

For many teens, nutrition and medication routines change after a kidney diagnosis.

• Fluids: Some people must limit how much they drink to prevent swelling or breathing problems, especially on dialysis.
• Minerals: Foods high in sodium, potassium, or phosphorus may need to be limited; your dietitian will give a tailored plan.
• Protein: Depending on your stage of kidney disease and treatment, you may be asked to eat a bit less or more protein.
• Medicines: Blood pressure pills, vitamins, or special medications for bone health, anemia, or transplant rejection must be taken exactly as directed.

Emotional Health and Support

Getting news about kidney failure or needing dialysis or a transplant can be emotionally overwhelming. It is normal to feel scared, angry, confused, or sad at times.

• Talking openly with parents, caregivers, or trusted adults can make it easier to cope.
• Many hospitals offer social workers, psychologists, or child life specialists to support teens with chronic illness.
• Peer groups — in person or online — can help you connect with others your age who are going through similar experiences.

Can Kidney Disease Be Prevented or Caught Early?

Not all kidney problems can be prevented, especially those related to birth defects or inherited diseases. But there are ways to reduce risk and catch problems earlier.

• Regular checkups — Routine visits with your doctor or pediatrician can reveal changes in blood pressure, growth, or urine tests before you feel sick.
• Prompt treatment of infections — See a doctor for urinary symptoms such as burning, frequent urination, or back pain, and finish all antibiotics as prescribed.
• Protecting your kidneys — Stay hydrated, avoid misusing pain medicines, and never use performance-enhancing or recreational drugs that may harm the kidneys.
• Managing other conditions — Teens with diabetes, high blood pressure, or autoimmune diseases should follow their treatment plans carefully, since controlling these helps protect the kidneys.

Frequently Asked Questions (FAQs)