Paediatric (Ped) Nephrology

Paediatric Nephrology is a medical subspecialty that focuses on the diagnosis and treatment of kidney diseases in children. Our team of paediatric nephrologists consists of highly trained and experienced medical professionals who are committed to providing the best possible care to our young patients. We understand the unique challenges of treating kidney diseases in children, and we work closely with our patients and their families to ensure that they receive comprehensive and compassionate care.

Our services include various diagnostic and treatment options, including:

• Evaluation and management of acute and chronic kidney diseases
• Diagnosis and treatment of congenital anomalies of the kidneys and urinary tract
• Management of high blood pressure in children
• Evaluation and management of electrolyte disorders
• Evaluation and management of fluid and acid-base disorders
• Management of kidney stones and urinary tract infections
• Renal replacement therapy, including hemodialysis, peritoneal dialysis, and kidney transplantation.

Conditions treated in the Paediatric Nephrology department:

The Paediatric Nephrology department treats several diseases. Some of them are:

1. Hematuria: Hematuria causes cola-coloured, red, and pinkish urine in the patients due to blood cells. The leading cause of hematuria in children is acute UTIs caused by bacteria. It also occurs when there's too much calcium in the child's urine.
2. Lupus Nephritis: Here, the child's kidney is damaged and inflamed due to (SLE) systemic lupus erythematosus. Symptoms may include hip blood pressure, blood in the urine, swelling in the ankles, and foamy urine.
3. Pediatric Hypertension: Hypertension is a sustained elevation in the patient's blood pressure. The risk factors for contracting pediatric hypertension may include being obese, having type 2 diabetes, high cholesterol, and a family history of high blood pressure. 
4. Solitary Kidney: Solitary kidney refers to a condition where the Patients baby has one kidney instead of two. The patients might have been born with only one kidney or lost one kidney due to infection and live on with only one functional kidney. Symptoms include a high level of protein in the urine and high blood pressure.
5. Proteinuria: It refers to excess protein in the urine. It is not exactly a disease in and of itself but a symptom of certain kidney conditions. The most common cause of Proteinuria includes High blood pressure, Diabetes, Fever, Emotional stress, and kidney inflammation.
6. Glomerulonephritis: When the patient suffers from glomerulonephritis, his/her kidney cannot clean the blood properly. Symptoms may include swelling in the face and hand and difficulty urinating properly.
7. Nephrotic Syndrome: In this condition, the kidney leaks huge amounts of protein into the patient's urine. This increases the chances of catching infections and swells body tissues. Kidney diseases affecting the kidney's filtering system are one of the significant causes of nephrotic syndrome in children. Other infections, medicines, and genetic disorders can also cause nephrotic syndrome.
8. Congenital Disabilities: Congenital disabilities in the kidney may lead to several diseases and infections. These defects could be passed down through genetics. Unilateral renal agenesis: Here, one kidney fails to develop properly in utero.Usually, people suffering from unilateral renal agenesis lead a normal and healthy life without any major complexities.
9. Bilateral Renal Agenesis: Here, both kidneys fail to develop in utero.This condition is life-limiting since the kidney never develops in the baby. Most of the time, babies suffering from bilateral renal agenesis are stillborns, and in the rare case of them making it out alive from the womb, they live only for a few hours.
10. Renal Hypoplasia: The kidney doesn't fully develop inside the womb. Due to its abnormal size, it doesn't function well enough like a regular kidney. Babies suffering from renal hypoplasia in both kidneys have very low chances of survival. If such babies survive, they must undergo several treatments like dialysis or may even require a transplant.
11. Kidney Stones: Kidney stones occur when an excess amount of uric acid is present in the child's urine. Severe pain in the groin, abdomen and lower back may hint toward possible kidney stones in the patients.

Types of treatments conducted in the Paediatric Nephrology department:

The pediatric nephrology department offers various treatments based on the patient's condition. A few treatments provided by nephrologists are:

1. Dialysis: Dialysis helps to filter blood and remove waste from the body of a child whose kidneys aren't functioning properly. It is used to treat infected kidneys with the potential of leading to kidney failure.
2. Kidney Biopsy: In a renal biopsy, a small tissue of the kidney is extracted and studied under a microscope to diagnose diseases and conditions. It is also conducted to monitor the progress of treatments.
3. Kidney Transplant: Here, the infected kidney of the patient is removed and replaced with a donor's healthy kidney. This procedure is opted for only if all other alternatives haven't been able to improve the patient's health.
4. Post-Kidney Transplant, rehabilitation, and care: Pediatric neurologists may conduct certain examinations to ensure that the newly transplanted kidney is functioning properly. They also detect and treat adverse effects caused by the transplantation procedure.
5. Kidney Stone Treatment: Kidney stones may occur in the patient's kidney if it contains too much uric acid. Doctors may attempt to treat the stone without surgery by making the patients consume more water.
6. Renal Angioplasty: This procedure is conducted to treat a narrow renal artery.

We take a multidisciplinary approach to care, working closely with other specialists such as urologists, radiologists, and nutritionists to ensure that our patients receive comprehensive and coordinated care. We understand that kidney diseases can be a source of stress for both patients and their families. Therefore, we strive to create a warm and welcoming environment that fosters open communication and trust between our patients, their families, and our medical team. We also provide educational resources and support services to help families manage their child's condition and optimise their health outcomes.

If your child is diagnosed with kidney disease or is experiencing symptoms such as blood in the urine, decreased urine output, or swelling in the legs and feet, we encourage you to schedule a consultation with our Paediatric Nephrology team. Our aim is to provide the highest quality care to our patients and help them achieve the best possible outcomes.

Review

Reviewed by Dr. Vinay K Agarwal, Associate Director - Pediatric Nephrology on 28-April-2023.