Kidney Care (Nephrology)

Our Approach to Care

Using a team approach, we provide seamless care to your child and family before, during, and after kidney transplant surgery. Your child's healthcare team includes professionals from a wide variety of disciplines. In addition to pediatric nephrologists, urologists, and transplant surgeons, the team includes specialists from nutrition, psychiatry, critical care, social work and other fields who collaborate to ensure that your child is as ready as possible for transplantation and receives comprehensive, compassionate care during and after the procedure. We also have dedicated pediatric transplant coordinators to help manage your transplant evaluation process.

What to expect from our kidney transplant programs

When you bring your child to NewYork-Presbyterian for kidney transplantation, you'll benefit from a customized team assembled to provide your child with exceptional care. Our programs feature:

Steroid-free regimens after transplant. Our teams have extensive expertise in immunosuppressant therapies and other medications that patients need to take after transplantation, caring for them throughout their lives. The team is generally able to avoid using steroids in children. Without steroids, patients recover quickly and avoid many serious long-term side effects, including growth delays.

Experienced reconstructive surgeons. Our pediatric urologists perform reconstructive surgical procedures to boost the chance of a successful outcome after transplantation by correcting bladder abnormalities in a child before the transplant. This may be a part of care for children with posterior urethral valves (extra flaps of tissue in a boy's urethra), abnormalities of the anus and rectum, cloacal disorders, and neurogenic bladder (lack of bladder control due to a brain, spinal cord, or nerve condition).

Education and guidance. You and your child receive comprehensive education to help you understand your options before transplantation and what you need to do to help your child thrive after transplantation and into adulthood.

Your first visit

Your family's first step in the journey toward kidney transplantation is a full evaluation by our transplant team. You will learn about:

• The types of kidney transplants we perform and what the transplant process entails.
• What you need to know if you are interested in donating a kidney to your child.
• What you'll need to do if your child is placed on the waiting list for a kidney from a deceased donor. You'll need to be reachable 24/7 and able to bring your child to the hospital quickly if a donor kidney becomes available.
• What your child's life will be like after transplantation. Your child will need to take medications and receive lifelong medical follow-up care, including periodic clinic visits, to stay healthy.

Your child will undergo a series of tests to evaluate his or her health in preparation for the transplant process. The team will also let you know what you can do to help your child stay as healthy as possible before the transplant takes place.

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 do the work of the kidneys. For pediatric patients, we often use this treatment as a bridge to kidney transplant. 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.