The Division of Pediatric Nephrology has excellent outcomes in the treatment of children with different kidney diseases, as well as those who ultimately require kidney transplantation. Infants and children with complex kidney diseases benefit from a full range of treatment options, including management of:
Kidney failure in children could lead to consequences that include growth failure, anemia, bone disease, and disruptions to acid base and electrolyte balance. Our pediatric nephrologists manage the kidney disease of children during the period that precedes and up to the time that they receive a kidney transplant, should that be necessary. Our aim is to manage the child with the goal of preventing the need for kidney transplantation. In other cases, we may be able to prolong the kidney’s ability to function.
Diagnostic Services – The Division’s comprehensive diagnostic capabilities include the full complement of radiology services. Kidney biopsies are routinely performed in children of all ages for diagnostic purposes. Biopsies are performed with ultrasound guidance and conscious sedation in our Pediatric Sedation Unit. In most cases patients are able to go home the same day as the procedure.
Dialysis – Very young children with end stage renal disease who might be too small to be considered for transplantation are generally placed on peritoneal dialysis since it can be done at home at night while the child and family sleeps. Peritoneal dialysis involves placement of the catheter into the abdominal cavity, making access easier than for hemodialysis, which requires access through a vein. Newborns can also start peritoneal dialysis at birth.
For school-aged children, peritoneal dialysis helps to normalize their lives, enabling them to attend school full-time and participate in their usual activities while getting treatment for kidney failure. Hemodialysis, which is recommended for children who are older, is performed at the Hospital or in a dialysis center. Since hemodialysis can be a three-hour process, volunteers or child life specialists are often available to interact with the children during this time.
Kidney Transplant – The Division of Pediatric Nephrology coordinates and provides comprehensive evaluation, care and follow-up of children who require kidney transplantation, including pre- and post-transplant counseling for patients and family members. Our Living Donor Program offers pre-emptive kidney transplantation. Leading edge therapies are used to help reduce the side effects of anti-rejection drugs, and we routinely use a steroid-free protocol.
Growth Failure Program – Our staff have specialized expertise in the management of children with growth failure resulting from chronic kidney disease.
Hypertension – Our capabilities include interventional radiology services for the evaluation of children who have hypertension as the result of a renovascular condition. We are the major referral center in the metropolitan area for our expertise in performing arteriographic studies to allow us to evaluate arteries in small children. We are also seeing increasing numbers of children with high blood pressure that may be related to being overweight. Our Division is currently participating in an NIH-approved protocol looking at children with obesity and hypertension, their vitamin D metabolism, and other aspects of their pathophysiology.
We offer 24-hour ambulatory blood pressure monitoring to evaluate children and adolescents with elevated blood pressure readings to distinguish those with “white coat” hypertension from those with an elevation of their blood pressure due to medical reasons. Our staff also participates in trials of blood pressure medications in children with high blood pressure and management of anemia in chronic kidney disease.