We discuss initiation and considerations of pediatric chronic hemodialysis as well as the monthly visit and importance of an interdisciplinary team. Guest experts include: Dr. Cherry Mammen, Assistant Professor and Dialysis Director at British Columbia Children's Hospital, Dr. Raj Munshi, Associate Professor and Dialysis Director at Seattle Children's, and Dr. Sarah Swartz, Assistant Professor and Dialysis Director at Texas Children's. References HD dose and UF rate associated with survival in pediatric patients: https://pmc.ncbi.nlm.nih.gov/articles/PMC8260402/
Dr. Carla Nester, Professor of Pediatrics and Internal Medicine and Division Director of Pediatric Nephrology as well as the Associate Director of Molecular Otolaryngology and Renal Research Laboratory at the University of Iowa and international expert in Complement Disorders, discusses atypical HUS. She reviews the pathophysiology, clinical presentation, evaluation, management and transplant considerations.
In this second episode of our two part series on pediatric hypertension, we talk to Dr. Tammy Brady, a pediatric nephrologist at Johns Hopkins, and Dr. Joshua Samuels, both a pediatric and adult nephrologist at University of Texas Houston. In this episode they review validated blood pressure cuff, home blood pressure monitoring, inpatient blood pressure concerns, end organ cardiac changes, end organ cardiac impacts of hypertension, and choice of antihypertensive.
In this first episode of our two part series on pediatric hypertension, we talk to Dr. Tammy Brady, a pediatric nephrologist at Johns Hopkins, and Dr. Joshua Samuels, both a pediatric and adult nephrologist at University of Texas Houston. In this episode they review ambulatory blood pressure monitors, the basis for our standards for diagnosing pediatric hypertension, the pathophysiology behind obesity increasing the risk of developing hypertension, and ensuring blood pressure is accurately measured.
On this episode, we discuss all things CAKUT-related with the Neonatal Kidney Collaborative. Guests include Dr. Sangeeta Hingorani, a pediatric nephrologist at Seattle Children’s, Dr. Samantha Schwartz, a Six2 crew member and pediatric nephrology fellow at Lurie Children's, Kara Short, a nephrology nurse practitioner at the University of Alabama, Dr. Cara Slagle, a Neonatologist at Indiana University and Lakesha, mother of Landon, a nephrology patient at the University of Alabama. This is a special episode focused on the patient and family perspective of pediatric kidney disease. Interested in neonatal nephrology? Check out the NKC website: https://www.babykidney.org/
In this episode of the podcast we focus on recurrent urinary tract infections, looking at how we diagnose UTIs, the diagnostic challenges, the causes of recurrent UTIs, and the management. We interview Dr. John David Spencer the division chief of pediatric nephrology at Nationwide Children's Hospital and Dr. David Hains the division chief of pediatric nephrology at Riley Children's Hospital who are both experts on the topic with extensive research into this arena and numerous publications. Marsh MC, Junquera GY, Stonebrook E, Spencer JD, Watson JR. Urinary Tract Infections in Children. Pediatr Rev. 2024 May 1;45(5):260-270. doi: 10.1542/pir.2023-006017. PMID: 38689106. Hains DS, Starr MC, Schwaderer AL. Glomerular Filtration Rate Changes Following UTI in Children With Vesicoureteral Reflux. JAMA Pediatr. 2024 Dec 1;178(12):1366-1368. doi: 10.1001/jamapediatrics.2024.4546. PMID: 39446735; PMCID: PMC11581724.
A NephMadness special episode on minimal change disease in kids, supported by the AJKD and NKF. Guests include Dr. Alvarez Elias, who is an AJKD executive team member, pediatric nephrologist and research scientist at Fresenius, and Dr. Mallory Downie, a pediatric nephrologist at McGill University with her own lab studying genetics behind kidney disease in kids, specifically nephrotic syndrome. We discuss the exciting pathophysiology breakthroughs in MCD and treatment of relapses. Please participate in NephMadness 2025 by following this link: https://www.tourneytopia.com/AJKD/NephMadness/SubmitPicks/Picks.aspx For more details on MCD in kids see this commentary: https://ajkdblog.org/2025/03/07/nephmadness-2025-minimal-change-disease-beyond-idiopathic-redefining-nephrotic-syndrome-for-the-modern-era/
Dr. Maria Diaz-Gonzalez de Ferris, MD, MPH, PhD, joins us for a conversation about her approach to transitions of care in Nephrology. She is a pediatric nephrologist at UNC Chapel Hill, the Director of the UNC Transition Program otherwise known as STARx. Through her research work focusing on healthcare transitions for children with medical complexity, she has developed a system of healthcare checkpoints and resources that assess autonomy and self-management. In this episode, we briefly discuss the importance of transitions of care, general guidelines and resources, approaches in specialized populations such as transplant/CKD/ESRD, and resources that are available to those interested in optimizing their local transitions of care infrastructure. Resources: National and International Guidelines International Pediatric Nephrology Association (IPNA): https://pubmed.ncbi.nlm.nih.gov/21832978/ AAP/AAFP/ACP Healthcare Transition Guidelines (for general health care transitions and transfer): https://publications.aap.org/pediatrics/article/142/5/e20182587/38577/Supporting-the-Health-Care-Transition-From Got Transition (online resource for general transitions of care): https://www.gottransition.org/ STARx Program Description: https://www.med.unc.edu/transition/about-us-1/ STARx Transition Tools (Healthcare passport, All you need is love transition syllabus, Transition Index readiness assessment, STARx questionnaire): https://www.med.unc.edu/transition/transition-tools/
Drs. Stu Goldstein, Professor & Director of the Center of Acute Care Nephrology at Cincinnati Children's, and Jordan Symons, Professor, Fellowship Program Director and Apheresis Director at Seattle Children's Hospital provide their expertise regarding pediatric acute kidney injury. We discuss the emergence of the sub-specialty of critical care nephrology, harms of fluid overload, utility of biomarkers, benefits of early AKI awareness and CRRT therapy and an individualized approach to the pediatric patient with an AKI. References AWARE Study NEJM 2016- https://pubmed.ncbi.nlm.nih.gov/27959707/ Renal Angina Index (RAI) validation 2014 Kidney Int -https://pubmed.ncbi.nlm.nih.gov/24048379/ Renal Angina Index & Fluid Overload Prediction BMC Neph 2021- https://pubmed.ncbi.nlm.nih.gov/34635072/ TAKING FOCUS-2 RAI + uNGAL improves outcomes Kidney Int. 2023- https://pubmed.ncbi.nlm.nih.gov/38106571/ Fluid Overload Review Ped Neph 2024- https://pubmed.ncbi.nlm.nih.gov/37861865/ Urinary NGAL Validation Kidney Int. 2024-https://pubmed.ncbi.nlm.nih.gov/39156146/ Urinary NGAL is FDA cleared in children! https://bioporto.us/pronephro-aki/
For this episode on ARPKD interviewed Dr. Lisa Guay-Woodford a clinician scientist at Children’s Hospital of Philadelphia who is a world-renowned expert on cystic kidney diseases. She was part of one of the teams that discovered the ARPKD gene and provides fascinating insight into the history and management of the condition. References ARPKD genetic variations: https://www.sciencedirect.com/science/article/abs/pii/S1096719209002947 Bilateral nephrectomy outcomes: https://www.nature.com/articles/s41598-020-71956-1
We talk to the experts in the Neonatal Kidney Collaborative (NKC) about the recently published guidelines regarding kidney follow-up for NICU graduates, a product of the NIH-supported workshop in 2024 spearheaded by Dr. Michelle Starr of Indiana University/Riley Children's Hospital. Guests include Dr. Marissa DeFreitas, pediatric nephrologist at the University of Miami, Dr. Matt Harer, neonatologist at the University of Wisconsin, Dr. Kat Gist, pediatric cardiac intensivist at Cincinnati Children's, Dr. Heidi Steflik, neonatologist at the Medical University of South Carolina, and Dr. Tom Forbes, pediatric nephrologist at Royal Children's Hospital in Melbourne, Australia. Links Kidney Monitoring for NICU Grads Follow-Up Guidelines: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2823652 AWAKEN study: https://pmc.ncbi.nlm.nih.gov/articles/PMC5933049/ Join the NKC! https://www.babykidney.org/
Dr. Matthew Sampson, a pediatric nephrologist and associate professor of pediatrics at Harvard Medical School, walks us through genetic testing for pediatric patients with kidney disease. He discusses indications for genetic testing and how to interpret results. He also talks about his lab and work as a genomics researcher. Episode References Sampson Lab: https://www.sampsonlab.org/ ClinVar: https://www.ncbi.nlm.nih.gov/clinvar/ KDIGO genetic testing guidelines: https://kdigo.org/wp-content/uploads/2022/05/KDIGO-Genetics-in-CKD-Conference-Report-Corrected-Proof.pdf NKF genetic testing guidelines: https://www.ajkd.org/article/S0272-6386(24)00871-0/fulltext CJASN Genomics of Kidney Disease Series: https://journals.lww.com/CJASN/Documents/collections/kidney.pdf
Join us for an episode on anemia of chronic kidney disease with two pediatric nephrology experts on the topic, Dr. Meredith Atkinson, Associate Professor of Pediatrics at Johns Hopkins, and Dr. Mark Hanudel, Associate Professor of Medicine at UCLA. We will explore the underlying mechanisms behind anemia of CKD, novel treatments for anemia, thoughts on preventing hemoglobin cycling in the setting of Epoetin Alfa, and various iron supplementation tips.
Join us for a journal-style episode covering 2023 CJASN article, "Timing of Kidney Replacement Therapy among Children and Young Adults." Drs. Nick Larkins and Simon Carter discuss the findings from the Australia and New Zealand Dialysis and Transplant Registry and compare and contrast it to United States, Canada and European data. Article link: https://pubmed.ncbi.nlm.nih.gov/37279903/
Dr. Clemens Bergwitz, an associate professor of endocrinology at Yale University, walks us through how to work-up and treat patients with calcium and phosphorus disorders. He helped to discover the disease HHRH (hereditary hypophosphatemic rickets with hypercalciuria) and has wonderful knowledge to share with listeners regarding the bone-mineral axis! References 2024 KIR Update on HHRH https://pubmed.ncbi.nlm.nih.gov/38364990/ 2009 Ped Nephrology Genetic causes of hypercalciuric nephrolithiasis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2770137/ TMP calculation and reference ranges https://www.nbt.nhs.uk/sites/default/files/Protocol%20for%20measurement%20of%20TmP.pdf
Join us to learn about hyperoxaluria from nephrolithiasis expert and division director of pediatric nephrology at Mayo Clinic, Dr. David Sas! We discuss pathophysiology, work-up and management of primary hyperoxaluria, including new game-changing therapies. Dr. Sas also answers other high-yield kidney stone management questions. Resources: Novodetect primary hyperoxaluria/nephrolithiasis genetic panel testing: file:///Users/student/Downloads/BpG_GTP-for-NovoDetect-Panels-Form_GTP-NVDT-2P-B.pdf Rare Kidney Stone Consortium (RKSC): 800-270-4637 or rarekidneystones@mayo.edu Resources for physicians and patients regarding all forms of rare kidney stone diseases Oxalosis and Hyperoxaluria Foundation (OHF): www.ohf.org Resources for patients, parents, and physicians regarding primary hyperoxaluria
Dr. Laura Hesemann, a med/peds-trained adult and pediatric nephrologist and Chair of Pediatrics at the University of Missouri, shares her expertise about SGLT-2 inhibitors and their utility in clinical practice.
Drs. Donna Claes, Vivian Shih and Annie Kouri (our co-host) discuss their roles as pediatric dialysis directors at their institutions. Donna Claes is an associate professor of pediatric nephrology and chronic dialysis director at Cincinnati Children's and Vivian Shih is an assistant professor of pediatric nephrology and acute dialysis director at Children's Hospital Colorado. We talk about the road to becoming a dialysis director, what the job entails, the challenges, the rewarding aspects of the job and tips for those who are considering stepping into this position at their institution.
Dr. Katherine Twombley, professor and chief of pediatric nephrology at the Medical University of South Carolina, shares her knowledge on FSGS recurrence after transplant. She discusses the diseases that cause FSGS and her strategy for managing these complex patients. Dr. Twombley is the director of dialysis and kidney transplantation, and does clinical research in the area of transplant. She is involved with leadership roles both in ASPN and AST. If you have any feedback or would like to come onto the podcast, please email doctoremilyz@gmail.com
As part of the leadership series of podcast episodes, this episode discusses life as a pediatric kidney transplant director. Dr. Jodi Smith, Seattle Children's transplant director and ASPN president, Dr. Gina Barletta, Phoenix Children's transplant director, and Dr. Sarah Kizilbash, co-host and University of Minnesota transplant director, talk about why and how they got to be transplant director, their program's structure, strengths, weaknesses and the greatest joys of their job. For more information about the ASPN transplant interest group, check out this link https://aspneph.org/transplant-interest-group/ or email jodi.smith@seattlechildrens.org For information about UNOS, check out the calendar of events https://optn.transplant.hrsa.gov/news/calendar-of-events/ For UNOS requirements to become a transplant physician, check out this link https://optn.transplant.hrsa.gov/media/2785/membership_requirements-for_pediatric_components.pdf