Great Ormond Street Hospital sees thousands of children with hundreds of different conditions throughout the year. As an international centre of excellence it deals with more complex and varied conditions than many other hospitals. However, some conditions are still very common – the condition it sees the most is kidney failure. At Great Ormond Street Hospital the focus of treatment for this condition is in Victoria Ward and Hippo Ward (for dialysis).

Kidney poster from GOSHWhat do Kidneys do?
The kidneys filter the blood to remove waste products and produce urine. The kidneys contain around a million tiny filtering units called glomeruli. As blood flows through the tubes in the glomerulus at pressure, waste products pass through the walls of the tubes to form urine.

Blood cells and other things such as protein cannot pass through the walls because they are too big. The urine then passes through small tubes (tubules) where fluids, salts and minerals are removed for recycling around the body before flowing to the ureters.

Kidney problems
The range of different kidney problems that Great Ormond Street Hospital doctors deal with is very wide, taking in amongst many others, those born with an absent kidney (renal agenesis), malformed kidneys, polycystic kidney disease and the appearance of kidney stones.

However, in terms of the frequency of occurrences at the hospital, kidney failure is the most frequent – on its own and in conjunction with other conditions.

Acute or Chronic?
There are two types of renal failure: acute and chronic.

Acute renal failure or acute kidney injury is the term used when the kidneys suddenly become unable to do the work expected of them: they are unable to remove salt, water and waste products from the bloodstream. In the diagnosis of acute renal failure your doctor will examine your child and ask questions about how your child became ill. Blood tests to look for waste products in the blood and urine tests to look for blood and/or protein in the urine are the main method of diagnosing acute renal failure.

In acute renal failure the aim of treatment is to remove the cause if possible and to keep the amount of salts and minerals at the correct levels in the body while the kidneys recover. Acute renal failure always requires a stay in hospital for close monitoring and treatment. Depending on the cause of the acute renal failure, dialysis may be needed.

Chronic renal failure (CRF) is a term used when the kidneys are not working as well as they should. The term implies that both kidneys are affected. This is because one normal kidney is enough to maintain normal kidney function throughout life.

When both kidneys are damaged, they cannot keep up with the work that is asked of them, so that they may slowly fail over the years. When their function becomes very poor, terms other than CRF are used, like ‘end-stage renal failure’ (ESRF). This term is not a very good one as it implies that there is nothing more that can be done, but in fact it means that there is a need for dialysis or transplantation to maintain good health.

For further information, please read the Information Sheets section of the Great Ormond Street Hospital website.

Support Group
The British Kidney Patient Association may be able to offer advice and support: Tel: 01420 47021 or 47022 Website: www.britishkidney-pa.co.uk

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