WHAT IS A NEPHROLOGIST?

If your child has kidney or urinary tract disease, bladder problems, kidney stones, or high blood pressure, a pediatric nephrologist has the special skills and experience to treat your child. Pediatric nephrologists treat children from infancy through late adolescence and in some centers up to young adulthood.

WHAT TYPES OF TREATMENTS DO PEDIATRIC NEPHROLOGISTS PROVIDE?

Pediatric nephrologists diagnose, treat and manage many disorders affecting the kidney and urinary tract, including kidney failure, high blood pressure, inherited kidney diseases, kidney stones, urinary tract infections and abnormalities in the urine such as blood and protein. They also know how to evaluate and treat problems with growth and development that are specifically related to chronic kidney disease. They are also skilled in helping patients transition from pediatric nephrologists to nephrologists and urologists that care for adult patients.

Pediatric nephrologists generally provide the following services:

• Dialysis
• Kidney transplantation
• Kidney biopsies
• The interpretation of x-ray studies of the kidney
• The interpretation of laboratory studies related to kidney disease
• Ambulatory blood pressure monitoring

Pediatric nephrologists are the coordinators of a team that includes specialized nurses, dieticians and social workers, all dedicated to the care of children with kidney diseases. They work closely with other physicians such as pediatric urologists, pediatric surgeons and pediatric radiologists.

TEST AND PROCEDURES

The test and procedures may include and is not limited to:

1. Peritoneal dialysis - This is the process of cleaning the blood by using the lining of the abdominal cavity as a filter.
2. Hemodialysis - Is the use of a machine to clean wastes from the blood after the kidney have failed.
3. Continuous veno-venous hemofiltration - Usually, hemodialysis is typically done for patients with kidney failure, however, if the patient has low blood pressure or other contraindicators to hemodialysis, this procedure may be a necessary alternative.
4. Renal biopsy - A small sample of kidney tissue is removed with a needle. This test is sometimes used to evaluate a transplanted kidney. It is also used to evaluate an unexplained decrease in kidney function, persistent blood in the urine or protein in the urine.
5. 24-hour ambulatory blood pressure monitoring - When your blood pressure is being measured as you move around, living your normal life. It is normally carried over 24 hours. It uses a small digital blood pressure machine that is attached to a belt around your body and is connected to a cuff around your upper arm.
6. Urianalysis - This is an examination of the urine by physical or chemical means. Urianalysis comprises a battery of chemical and microscopic tests that help screen for urinary tract infections, renal disease and diseases of other organs that result in abnormal metabolites appearing in the urine.
7. Kid function tests - Blood or urine is commonly collected to test for how the kidneys are functioning. Some kidney test functions include:Measurement of glomerular filtration rate - This test measure how well the kidneys filter waste products from the body.
   1. Creatinine - This is a chemical waste product in the blood that passes through the kidneys to be filtered and eliminated in urine. The chemical is a by-product of normal muscle function.
   2. Creatinine urine - This is a test measurement to check the amount of creatinine in your urine.
   3. Creatinine clearance - This is a measurement of the kidney's ability to handle creatinine, which helps to estimate the rate of blood flow through the kidneys.
   4. BUN test - This test measures the amount of nitrogen in your blood that comes from the waste product area, and tests to see how well your kidney are working.
8. Urine supersaturation - or kidney stones.
9. Stone analysis - This is a test done to see what chemicals are in kidney stones.
10. Hypertension work-up - In general, the evaluation of hypertension primarily involves accurately measuring the patient's blood pressure, performing a focused medical history and physical examination, and obtaining results of routine laboratory studies.