Managing Water Quality for Children with Kidney Issues: Essential Tips

Q: Managing Water Quality for Children with Kidney Issues: Essential Tips

Hello：<br>1. <br>Although there are congenital kidney malformations, most kidney functions are normal at birth. <br>Of course, infants under one year old still have developing kidneys, and drinking water with high mineral content can increase the burden on their kidneys, making i

If there are issues with kidney function, should the quality of drinking water be more strictly regulated?

Hello Doctor: My daughter was diagnosed with "two sets of ureters = four kidneys" while still in the womb, but one of the kidneys has "cystic dysplasia" and the doctor said it is hydronephrosis.
Currently, she has undergone a urethral examination, and there is no issue with reflux.
The attending physician suggested that after she turns six months old, it would be easier to find a vein for intravenous therapy to assess kidney function.
If the hydronephrosis resolves on its own, that would be ideal; however, if it increases in size, surgery may be necessary to remove it.

Currently, my daughter is living in a rural area with my in-laws, where the water source is spring water from the mountains.
Although we have an RO reverse osmosis filtration system at home, the filtered water is still boiled.
However, due to the high level of impurities in the spring water, we are concerned about the potential for parasite eggs to be present.
Given my daughter's congenital kidney dysfunction, would drinking spring water place an additional burden on her kidneys?
We are also considering purchasing commercially bottled "mineral water" to boil and use for her formula and drinking.
Would this be a better option? What should we be particularly cautious about for a baby with kidney abnormalities? If there were to be urinary reflux, what symptoms would we observe? If previous examinations showed no signs of reflux, is there still a possibility of it developing later?

Tian Tai Tai, 0~9 year old female. Ask Date: 2007/03/14

Dr. Pei Rensheng reply Pediatrics

Hello:
1.
Although there are congenital kidney malformations, most kidney functions are normal at birth.
Of course, infants under one year old still have developing kidneys, and drinking water with high mineral content can increase the burden on their kidneys, making it unsuitable for young infants.
If spring water contains too many minerals, it is not appropriate for preparing formula for babies.
However, boiling the water first eliminates the possibility of parasites or bacteria.
2.
Distilled water is produced by heating water to boiling, evaporating it into steam, and then cooling and condensing it back into liquid form.
During the heating process, harmful organic compounds such as chlorine and trihalomethanes can evaporate and be expelled through the exhaust.
Prolonged boiling can kill all bacteria and filterable viruses in the water.
When water is converted to steam, substances like lime, rust, heavy metals, and sediment do not evaporate and are separated from the steam, settling out.
At this point, the steam is free of contaminants, and after passing through a cooling coil and condensing, it becomes clean drinking water at room temperature.
Therefore, distilled water is the safest choice for preparing formula or mixing juices for infants.
If purchasing bottled water for preparing formula, distilled water is recommended.
3.
Congenital kidney malformations should be evaluated by a pediatric nephrologist, who will provide recommendations based on clinical conditions, typically suggesting ultrasound or blood tests to check kidney function every six months.
It is important to monitor the types of medications used to avoid increasing the kidney burden.
4.
Urinary reflux may present with no symptoms or may lead to recurrent urinary tract infections.
In severe cases, it can manifest as hypertension or renal failure.
5.
If previous examinations did not show reflux, it is unlikely to develop later unless there is a subsequent mass in the urinary system causing obstruction, which could lead to reflux, although the incidence is very low.
Wishing you health and happiness!
Sincerely,
Pei Ren-Sheng

Reply Date: 2007/03/14

More Info

When managing water quality for children with kidney issues, especially those with congenital abnormalities like your daughter, it is crucial to prioritize safety and minimize any potential risks that could exacerbate her condition. Given your daughter's unique situation, where she has a complex renal anatomy and a history of hydronephrosis, careful consideration of her drinking water is essential.

Water Quality Considerations
1. Source of Water: Since your daughter is currently living in a rural area where the primary water source is spring water, it is important to assess the quality of that water. Spring water can contain various impurities, including minerals and microorganisms, which may pose a risk to a child with compromised kidney function. The presence of contaminants could lead to additional strain on her kidneys, which are already under stress due to her congenital condition.

2. RO Water Filtration: The reverse osmosis (RO) system you have installed is a good choice for purifying water. RO systems effectively remove a wide range of contaminants, including heavy metals, bacteria, and other impurities. However, it is essential to ensure that the system is well-maintained and the filters are changed regularly to ensure optimal performance. Boiling the water after filtration can further eliminate any remaining pathogens, making it safer for your daughter.

3. Bottled Water: Purchasing bottled water, particularly distilled or purified water, can be a suitable alternative. Distilled water is free from minerals and impurities, making it an excellent choice for mixing formula or for direct consumption. However, be cautious with mineral water, as it can contain high levels of minerals that may not be suitable for infants and could potentially increase the burden on her kidneys.

Nutritional Considerations
Children with kidney issues often require a diet that is low in sodium and potassium, as well as limited protein intake, depending on their specific condition. It is advisable to consult a pediatric nephrologist or a dietitian specializing in renal nutrition to create a tailored dietary plan for your daughter. This plan should consider her overall health, kidney function, and any other medical advice provided by her healthcare team.

Monitoring and Symptoms
Regular monitoring of kidney function is crucial. Your daughter's healthcare provider may recommend routine ultrasounds and blood tests to assess her kidney status and ensure that there are no changes in her condition.
Regarding urinary reflux, it is important to be aware of potential symptoms, which can include:
- Frequent urinary tract infections (UTIs)
- Fever
- Pain during urination
- Unusual changes in urine color or odor
- Abdominal pain
If your daughter has previously been assessed and found not to have reflux, the likelihood of developing it later is low, but it is not impossible. Changes in her anatomy or new developments in her condition could potentially lead to reflux, so ongoing vigilance is necessary.

Conclusion
In summary, for your daughter with kidney issues, using purified water from a reliable source is essential. RO-filtered water, when boiled, is a safe option, and bottled distilled water can also be considered. Regular monitoring of her kidney function and being aware of any symptoms of urinary reflux will help manage her condition effectively. Always consult with her healthcare provider for personalized advice and recommendations tailored to her specific needs.

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