Nephrology and kidney transplantation – Specialties
Kidney (renal) disease
Kidney (renal) disease can interfere with physical and mental developmental processes and can place children at high risk of contracting infections, bone disease and cancer through long-term use of immunosuppressive drugs. Children whose condition worsens to end-stage renal disease — also called ESRD or kidney failure — must be placed on dialysis or undergo a kidney transplant. Physicians may prescribe urine tests, blood tests, X-rays, ultrasound, computerized tomography (CT), a kidney biopsy or other means to evaluate and diagnose suspected kidney ailments.
Kidney transplantation offers the best outcomes for children with kidney failure, but complications including slow rejection of transplanted organs may require subsequent transplants. The Pediatric Nephrology Clinic is involved in preparing patients for surgery and in coordinating their post-surgical care and recovery. UC Davis Health ranked seventh in the nation for kidney transplants in 2020.
Children typically require dialysis for either of two principal reasons:
- For chronic kidney conditions
- For acute kidney failure
The Department of Nephrology coordinates with the Department of Internal Medicine in administering kidney dialysis for chronic conditions. In conjunction with the Pediatric Intensive Care Unit, we also provide state-of-the-art continuous hemodialysis procedures for critically ill children. While the hemodialysis we provide within our facility is the predominant approach in treating chronic conditions, we also train patients and their parents to perform acute peritoneal dialysis at home.
Outpatient peritoneal dialysis
Launched in 2016, the outpatient peritoneal dialysis program at UC Davis Children’s Hospital provides pediatric patients and their families with training on home-based peritoneal dialysis, while patients await a kidney transplant.
UC Davis Children’s Hospital is the only hospital in the region to offer outpatient dialysis for patients under 10 years of age or 44 pounds.
“Our patients have excellent outcomes and incredibly low infection rates. Many of our children require dialysis for 10-12 hours a day. Our program enables them to get that care safely at home from their parents or caregivers,” said UC Davis pediatric nephrologist Maha Haddad, who leads the program. “I’m very proud of the training that our team provides. We have not had one family refuse this training.”
Some of the program’s highlights and its successes:
- Zero exit site infections
- Decreased peritonitis rates
- High patient satisfaction levels
- Virtual visits (telehealth appointments) for patients within the 33-county area that the hospital serves
- Timely referrals to transplant in collaboration with the UC Davis Transplant Center
- Provides home dialysis training in English and Spanish from two dedicated dialysis nurses
- Offers home visits and 24/7 access to an on-call nephrologist for urgent questions and needs
- Includes access to a patient support group where families on dialysis can connect with each other.
- Dialysis machine, all supplies and fluids are delivered to the home
- UC Davis Children’s Hospital is a member of the Standardized Care to Improve Outcomes in Pediatric Endstage Kidney Disease (SCOPE) collaborative, which prevents infections in children and adolescents on peritoneal dialysis and hemodialysis uusing large-scale collaboration to identify and spread effective interventions across pediatric care settings.
Pediatric kidney stone program
Urinary stones in children are uncommon and require specialized care. The workup and treatment of pediatric stone disease is different in that children tend to have identifiable chemical imbalances, have a higher recurrence rate, are more susceptible to radiation from imaging studies and the smaller size of organs makes surgical treatment more difficult.
The mission of the UC Davis Children’s Hospital Pediatric Kidney Stone Program is to provide comprehensive care to children and families with heightened attention to these issues. We are a multi-disciplinary team of urologic surgeons, pediatric nephrologists, nurses, registered dietitians and a social worker. We offer the most up-to-date minimally invasive treatments and prevention programs.
We have two clinic locations:
- Pediatric KIDney Stone Clinic at the Lawrence J. Ellison Ambulatory Care Center (ACC): We identify pediatric patients with kidney stones, evaluate them for other urologic abnormalities that are associated with kidney stones, and determine if the kidney stones require surgical management or can be observed. Pediatric patients who are first time kidney stone formers, or are new UC Davis Health, should be seen at this clinic.
- Multidisciplinary Pediatric Stone Clinic (MPS) at the Glassrock Building: We provide comprehensive, multidisciplinary care for pediatric patients with kidney stone disease. This clinic brings together the knowledge and extensive experience of pediatric nephrologists, endourologists, pediatric dietitians and a social worker to help manage pediatric kidney stone patients who are at high risk for kidney stone recurrence. The emphasis of this clinic will be on imaging surveillance, and dietary and medical prevention for recurrent kidney stone disease.
For questions about our program, please contact Paula Wagner, N.P. at 916-734-8482.
Diagnostic and therapeutic services
The Nephrology Clinic also cares for numerous patients with other diseases such as lupus (also known as SLE or Systemic Lupus Erythematosus) because that disease often affects the kidneys. Lupus, which can emerge in puberty, predominantly affects teenage girls.
The diagnostic and therapeutic services performed by our nephrology staff include:
- Peritoneal dialysis
- Continuous dialysis (also called CRRT or CVVH)
- Renal biopsy
- Evaluations and treatments for disorders including nephrotic syndrome, high blood pressure, kidney infections, hydronephrosis and kidney stones
- Renal transplantation
In addition to serving UC Davis Children's Hospital clinical patients, our nephrologists are widely sought for consultation services by family practitioners who have patients with kidney disease. Our team also provides consultation services to hospitals in the entire Sacramento area, Northern California, Southern Oregon and parts of Nevada.