When kidneys fail to function adequately to remove the toxins and fluid replacement of the kidney function is needed. You may need one of the treatments described below.
Some children with end-stage kidney disease are best treated by hemodialysis, a procedure where blood is removed from the body and pumped through a hemodialysis filter (an artificial kidney), where it is cleaned and simultaneously returned to the child.
Peritoneal dialysis is a special type of dialysis where a sterile solution of sugar and a salts are infused into the abdomen, then drained. The treatment is able to remove toxins and fluid. One of the advantages of peritoneal dialysis is that patients can receive this form of therapy at home.
Continuous Renal Replacement Therapy
Sometimes, peritoneal dialysis is not the right choice, and the child’s blood pressure does not allow for regular hemodialysis. For these children, who are mostly admitted to the intensive care unit, a slow form of hemodialysis called continuous renal replacement therapy (CRRT) is used.
We have developed unique treatment options for very sick children in intensive care, including using CRRT and plasmapheresis at the same time. A special technique, rapid exchange of continuous renal replacement therapy (RECRRT), is now being routinely used to decrease the amount of blood exposure for the child and reduce the variability of blood pressures that often happens without RECRRT.
Our team is also skilled at providing apheresis, including plasmapheresis (the removal and replacement of plasma), red cell pheresis (the removal and replacement of red blood cells), leukopheresis (the removal of white blood cells), and even stem cell collections (for patients who need bone marrow transplants).
Kidney Transplant Program
Rady Children’s Pediatric Kidney Transplant Program has two new outstanding surgeons, Kristin Mekeel, M.D., and Alan Hemming, M.D. Dr. Mekeel trained at the University of Florida and practiced at the Mayo Clinic in Scottsdale, Ariz., prior to moving to San Diego.
Our transplant program has a shorter waiting time than other organ procurement organizations in Southern California. Moreover, the program has been seeing an expansion of living related donors due to the University of California, San Diego robotic organ donation program. Robotic donation decreases hospitalization time and adverse events.
For those patients who have family members who want to donate but are unable to do so due to blood group incompatibility, we provide a paired organ donation program. Paired organ donation allows a person to swap donor kidneys with other people in the United States, thus allowing both recipients to receive a living kidney transplant.
Our transplant program also has a very skilled group of urologic surgeons who work closely with Dr. MeKeel.