Rady Children’s neonatal intensive care unit offers the full spectrum of medical and surgical management for newborns and infants with renal dysfunction and renal failure, including peritoneal dialysis, hemofiltration, hemodialysis and CRRT (continuous renal replacement therapy).
In conjunction with our programs in Nephrology, Urology, Pediatric Surgery and Radiology, we are able to provide this highly specialized care to patients with potentially reversible AKI (acute kidney injury)/ARF (acute renal failure) and those with CRF (chronic renal failure) due to structural anomalies including obstructive uropathies, such as posterior urethral valves, polycystic/dysplastic kidneys, or even renal agenesis, and who will eventually need renal transplants.
Many of our patients are diagnosed and referred to our center prenatally, while others are transported from other hospitals in Southern California and the western United States, including Hawaii, Guam and Saipan. Rady Children’s is also able to offer state-of-the-art genetic testing through the Rady Children’s Institute for Genomic Medicine to further delineate the diagnosis and prognosis for a number of these patients and also allow for earlier and more optimal treatment plans.
We are also able to provide the highest level of cardiorespiratory support, including HFOV (high-frequency oscillatory ventilation), Heliox and ECMO (extracorporeal membrane oxygenation) for those infants with ARF or CRF who have multiple significant conditions, including pulmonary hypoplasia due to associated oligohydramnios, overwhelming sepsis, HIE (hypoxic ischemic encephalopathy) or metabolic disorders, particularly hyperammonemia. The adjunctive use of hemofiltration and CRRT in patients on either respiratory or cardiac ECMO support has been a hallmark of our program for over 30 years.
- Acquired kidney diseases, including ATN (acute tubular necrosis) due to hypoxia, asphyxia, hypotension, septic shock, CHD (congenital heart disease) with decreased renal perfusion, cardiomyopathy, vascular events (renal artery or vein thrombosis) or medications
- Congenital malformations, including renal dysplasia, hypoplasia, agenesis, renal cysts, including those with known genetic etiology
- Obstructive uropathy, including PUV (posterior urethral valves), UPJ (uretero pelvic junction) obstruction, UVJ (uretero vesicular junction) obstruction, severe VUR (vesico ureteral reflux)
- Metabolic disorders (inborn errors of metabolism) causing hyperammonemia, including urea cycle defects, organic acid disorders or fatty acid oxidation defects