What is Pediatric Nephrology?

Pediatric nephrology sees children with diseases of the kidneys and urinary tract. Infants, children and adolescents affected with kidney disease may have:

• high blood pressure
• abnormal blood electrolyte levels
• anemia or a low red blood cell count
• softening of the bones/renal osteodystrophy
• malnutrition requiring supplemental nutrition
• heartburn/gastro esophageal reflux
• poor growth and delayed development
• kidney stones

Some infants, children or adolescents have more advanced disease with kidney failure (including those requiring dialysis), and require assessment for kidney transplant or have already received a kidney transplant.

Pediatric nephrologists at the University of Alberta work with a multidisciplinary team to provide excellent comprehensive care to allow our patients and families to meet their full potential.

Unique Highlights

The Division of Pediatric Nephrology sees patients starting with prenatal consults for developmental disorders of the kidney, all the way through to adulthood. Our service is a busy academic nephrology centre, with an emphasis on assessment and management of quaternary care nephrology. We work closely with our colleagues in urology, rheumatology, intensive care, neonatology and with other organ transplant services to meet the complex needs of a growing population of children with diverse, and multi-system medical conditions.

As internationally recognized experts in kidney stones in children, our division was the first to demonstrate an epidemiological link between kidney stones and the increased risk of chronic renal failure. Our clinical program is actively supported and generously funded by a clinical and basic research focus in kidney stones in children.

Acute kidney injury (AKI) in children is increasing in children with complex multisystem disease. Our centre has international collaborations and recognized expertise, particularly in the field of AKI epidemiology.

The geography we cover to deliver pediatric kidney services is among the largest in North America. Clinically, our patient population extends into Saskatchewan, northern B.C., Northwest Territories, Nunavut and northern and central Alberta.

Members of our division have administrative roles at the University, Alberta Health Services, the Canadian Association of Paediatric Nephrology, Canadian Society of Nephrology, KRESCENT (Kidney Research Scientist Core Education and National Training Program), CIHR (Canadian Institutes of Health Research) and the Royal College of Physicians and Surgeons of Canada. Our administrative roles span education, clinical advocacy, quality improvement and research.

Research

Our division is internationally recognized for the innovation its members have created. We lead and participate in collaborative studies and trials contributing to the improvement of care and understanding of basic mechanisms of disease in pediatric nephrology. Current areas of study include:

• kidney stones, hypercalciuria and renal calcium regulation
• acute kidney injury in congenital cardiac disease and intensive care populations
• prevention of renal toxicity in pediatric oncology patients
• medical education innovation in postgraduate pediatrics and nephrology

We currently hold in excess of $2 million in research funding, through agencies such as the Kidney Foundation of Canada, Canadian Institute for Health Research, National Science and Engineering Research Council, the Royal College of Physicians and Surgeons of Canada, as well as other regional and local funding bodies. 

Education

We offer a fully accredited Royal College Pediatric Nephrology Residency Program. Trainees will learn to evaluate children with kidney disorders including electrolyte disturbances, hematuria, proteinuria, glomerulonephritis and urinary tract infections.

Our faculty have been recognized within the Department of Pediatrics, Faculty of Medicine and Dentistry and within the national education community for excellence in teaching at the undergraduate and postgraduate levels. We have created innovative curricula in evidence based medicine, research methodology, pediatric nephrology, and quality improvement.

Clinical Care

We provide excellence in clinical care to the children and families from our referring regions of Western and Northern Canada. We are one of two centres in Alberta that provide comprehensive services for kidney disease, including diagnostic kidney biopsy, dialysis through a tube in the abdomen (peritoneal dialysis) and dialysis through a blood access line (hemodialysis).

In addition, we provide therapies such as apheresis (where the liquid part of a patient’s blood is replaced), and comprehensive kidney transplant care for children.

Our service operates an inpatient service and consult service, as well as outpatient clinics in:

• general nephrology
• vasculitis
• solid organ transplant
• kidney transplant
• acute kidney injury
• complex urologic disorders
• dialysis follow-up
• kidney stones

We are part of the Northern Alberta Renal Program, and work closely with our adult colleagues to provide these services to children from Northern Alberta, Northern BC, Saskatchewan, the Northwest Territories, and Nunavut. Our service sees over 3,300 patients annually, of which approximately 30 per cent are from outside of Edmonton.

Children with kidney disease and their families will find our service family-centred; we support the medical and social needs of children with kidney disease, as well as those that provide care for these children. Patients may encounter many different team members depending on their needs, including clinic and inpatient nurses, dieticians, social workers, transplant coordinators, and dialysis staff. We practice in multidisciplinary clinics where specialists work together to collaborate and coordinate medical and surgical care for our patients, easing the burden on families who would otherwise need to attend multiple appointments.