When most people think of kidney disease, they picture a middle-age adult hooked up to a dialysis machine.

But the disease can also show up in the womb, and that means thousands of children are born with a lifetime of treatment ahead of them.

But kidney disease in children can be managed.

Children who have kidney disease are at risk of stunted growth, becoming anemic and bone disease, doctors said.

But with so many treatment options available now, doctors are ready to help children fight it.

Natalie Trumbo is 22 months old and is hitting all of the major milestones: She's learning to eat with a fork and becoming very talkative.

But even before birth, her kidneys were way behind, and as a first-time mother, Sheila Trumbo was terrified.

"(The doctor) said 'Well, I had a friend in college who had this problem, and he passed away from it.' And OK, I was like, 'What? My kid's going to die?' I was freaking out," Sheila Trumbo said.

Natalie has problems with both of her kidneys.

On one side, she has a blockage, and on the other she has reflux nephropothy.

That's when urine shoots back up into the kidney instead of going through the bladder, and it puts a strain on the kidney.

Natalie's mother takes her in for an ultrasound every three to six months, and she's on daily medication.

But now and then, the kidney condition takes over.

"She spikes a really high temperature. So it goes up to like 103, and she just acts miserable," Sheila Trumbo said.

Dr. David Rozansky is a kidney expert at Doernbecher Children's Hospital. He said almost all adults with kidney failure get it from high blood pressure or diabetes.

But in young children, the disease is the result of a kidney that isn't fully formed, a reflux problem or damage to the kidney's filtering system.

"The kidney is known as the silent organ. So in many cases, the patient will show up too late or be missed initially," Rozansky said.

Rozansky said the child's diet is key.

"They will have to change their diet. First to make sure they have good bone growth -- have to get lots of vitamin D and a low-phosphorous diet."

Doctors said Natalie will have to have surgery when she's 5.

But beyond that, they said good nutrition and regular exams will keep her on the right track.

If a child's kidney starts functioning below 40 percent, they may need a transplant.

But the life span of a transplanted kidney may be only about 15 years.

And after that, the patient will have to get another one.

Childhood Kidney Disease Strikes Before Birth