Kidney Care (Nephrology)

The first step in your child's care is obtaining an accurate diagnosis of the cause of their symptoms. At NewYork-Presbyterian, we undertake a comprehensive evaluation of your child’s kidneys using tools such as:

• Urine tests to check for the presence of abnormalities such as blood, various proteins, and signs of infection. They also help us evaluate electrolyte abnormalities.
• Blood tests to determine how well the kidneys are working.
• Imaging studies to see the size, shape, structure, and function of your child's kidneys and to assess for any abnormalities.
• Kidney biopsy. A biopsy is the removal of a very small piece of kidney tissue to look at it under a microscope. If it is determined that a kidney biopsy is needed, we do it as a same-day procedure under ultrasound guidance with moderate sedation. You can usually take your child home the same day as the biopsy.

Pediatric blood pressure monitoring

Hypertension is the leading cause of kidney disease in adults. High blood pressure can cause kidney disease in children, too, which if left untreated can worsen kidney function. We offer specialized tests to monitor your child's blood pressure and reduce the chance that your child will develop complications related to hypertension, including:

• Arteriography to evaluate the arteries in the kidneys. NewYork-Presbyterian is the main referral center for these procedures in the New York metropolitan area.
• 24-hour ambulatory blood pressure monitoring, which measures blood pressure at regular intervals throughout your child's day. It is more accurate than the blood pressure measurements we take in the office.
• Monitoring for complications of hypertension. We routinely perform echocardiograms, lipid profile testing, eye exams, and microalbuminuria checks in children with hypertension.

Treatments we offer

Once we have diagnosed kidney disease, we will determine if it can be treated with medication, dietary changes, dialysis, or kidney transplantation.

Customized medical therapies

Lowering a child's elevated blood pressure can significantly slow the progression of kidney disease. We often use a combination of medications to lower blood pressure. If your child's kidney disease is more advanced, he or she may need treatment for anemia and growth failure.

• Anemia treatment. We may treat anemia using the hormone erythropoietin, which is normally produced by the kidneys and stimulates the bone marrow to produce red blood cells.
• Growth failure. We may treat growth failure through dietary changes, food supplements, and/or growth hormone injections.

Nutritional counseling

Specific elements in your child's diet can affect how well his or her kidneys work — particularly protein, sodium, potassium, phosphorus, and fluids. Our renal nutritionists are experienced in helping children and families make and maintain dietary changes, which will benefit their kidney health.

Dialysis

Kidney disease can sometimes lead to kidney failure. If your child's kidneys are no longer able to function properly, we use a technique called dialysis to perform the work of the kidneys. For pediatric patients, we often use this treatment as a bridge to kidney transplantation. The quality of life after a transplant is always better than it is while on dialysis.

• With peritoneal dialysis, we place a catheter into your child's abdomen, making access to body fluids easier. This approach is often used in newborns and very young children since it can be done at home at night while the child and family sleep.
• With hemodialysis, we access the bloodstream through a vein. It is reserved for older children and is given at the hospital or in a dialysis center.

A leader in pediatric kidney transplantation

If your child's kidneys have stopped functioning, we may recommend a kidney transplant. Our transplant teams are skilled in transplanting adult kidneys — which have more reserve and usually function better than pediatric donor kidneys — into children. Through our team approach, we provide continuity of care to your child throughout his or her illness and treatment. We offer your child and family comprehensive transplant counseling from the time you decide to move forward with transplantation to the surgery and throughout the recovery period. Learn more about our pediatric kidney transplant programs.