Nephrology (Kidney Health)

mom and daughter rubbing noses

A child may be born with a kidney condition or acquire one through disease or infection. Our pediatric nephrology (kidney care) specialists evaluate and treat a wide range of kidney (renal) problems in children, including urinary tract infection, high blood pressure, and kidney damage caused by diseases such as acute glomerulonephritis, lupus nephritis, and chronic kidney disease.

 
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Some of the kidney problems we evaluate include:
  • hematuria (blood in the urine)
  • proteinuria (protein in the urine)
  • kidney stones
  • urinary tract infections
  • bedwetting (enuresis)
  • dysfunctional voiding: a group of bladder symptoms that may occur together and include frequent urination during the day, urinary accidents during the day, the urge to urinate, and an inability to sense when the bladder is full
  • high blood pressure (hypertension)
  • nephrotic syndrome: a group of symptoms that occur together and include edema or body swelling, protein in the urine, low blood protein levels, and high blood cholesterol
  • polycystic kidney disease: a hereditary disorder in which multiple cysts, at least two or more, form in both kidneys
  • renal tubular acidosis: a condition that involves an accumulation of acid in the body due to the kidneys’ failure to filter urine properly
  • glomerulonephritis: inflammation of the glomeruli, the structures inside the kidney that help to filter the blood
  • effects of structural birth defects on the formation of the urinary tract such as hydronephrosis (swollen kidney), obstruction (blockage), vesicoureteral reflux, and renal agenesis (born with one kidney)
  • multicystic kidney disease: abnormal fetal development that leads to the development of multiple cysts in the place where a kidney should be
  • Fanconi syndrome: a disorder of the small kidney tubes in which certain substances normally absorbed into the bloodstream by the kidneys are released into the urine instead
  • acute renal insufficiency: a rapid, sudden decrease of kidney function due to damage, inflammation, or injury
  • chronic kidney disease: a slow worsening of kidney function over time due to disease
  • end-stage renal disease (ESRD)/chronic kidney disease stage 5: when chronic kidney disease has progressed to the point that the kidneys are completely or almost completely unable to remove water and clean the blood of toxins
  • systemic lupus erythematosus: autoimmune disease (when the body’s immune system reacts against itself) associated with kidney problems such as hematuria, proteinuria, hypertension, and/or glomerulonephritis

Orlando

Nemours Children's Clinic, Orlando

1717 South Orange Avenue, Suite 100
Orlando, FL 32806
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For Appointments: (407) 650-7715

Hours: Monday–Friday, 8 a.m. to 5 p.m.
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What to Bring
  • photo ID
  • medical and pharmacy insurance cards
  • preferred pharmacy name and phone number
  • names and dosage of all medications, including over-the-counter medication, your child is currently taking
  • guardianship and custody papers, if a legal guardian rather than a parent accompanies your child
 
Helpful Resources
Resources for Patients & Families

Pediatric nephrology specialists (kidney specialists) based out of the Nemours Children’s Hospital will travel on a weekly basis to our clinic in downtown Orlando (Orange Avenue) to provide consultation, evaluation, and treatment for children with a wide range of kidney problems.

Patients requiring hospitalization are admitted to the Nemours Children’s Hospital or to the Florida Hospital for Children in Orlando.

Acute dialysis is done at either of these hospitals and chronic dialysis (long term) is provided at the Central Florida Kidney Center.

What to Expect at a Visit

At your child’s first visit, we'll perform a thorough physical exam and take a complete family history. We will also likely order blood tests, urine tests, and imaging studies — renal ultrasounds and in certain cases, CAT scans or nuclear medicine studies. These tests assess the structure and function of your child’s kidneys. In some cases, depending upon your child’s symptoms and other test findings, a percutaneous (through the skin) kidney biopsy may be performed to assist in a diagnosis.

Because many kidney problems overlap with diseases of the urinary tract, we often work closely with specialists from urology. Other specialists, such as rheumatologists may also be involved, as in the case of lupus-related kidney disease. Together, we can offer the most up-to-date and effective treatment plan for your child.

How We Treat the Condition

Treatment options can vary widely depending on your child’s stage of disease. Some kidney problems may require diet modifications, medication, or surgery to correct an anatomical defect, while others might require long-term dialysis or a kidney transplant. Our staff also has expertise in managing the many side effects children experience as a result of renal failure, including stunted growth.

Chronic Kidney Disease Stage 5 Program

For children with chronic kidney disease stage 5/end-stage renal disease, our pediatric nephrology program offers several treatment options, including:

Dialysis: When the kidneys are no longer able to filter the blood, a machine can do the job for them.

Our program offers two types of dialysis:
  • Hemodialysis: A process that allows your child’s blood to flow a few ounces at a time through a large machine while a special solution called dialysate removes waste products. The clean blood is then returned to your child’s body. This happens in a hospital and is usually performed several times a week for at least 4 hours.
  • Peritoneal dialysis: A process that uses your child’s abdominal cavity to “clean” the blood. Dialysate fluid is introduced through a long soft tube that is placed in the abdomen and flushed out either every night while your child sleeps or several times throughout the day. Vast improvements in dialysis technology and clinical expertise enable even the smallest children, including newborns, to receive safe, effective dialysis. Peritoneal dialysis is preferentially used to treat young, small patients since families can be trained to handle this procedure at home.

Continuous renal replacement therapy: This technique, mostly used for inpatients, allows dialysis to occur slowly, over a 24-hour period.

Kidney transplant: This is the preferred option and nearly all children with chronic kidney disease stage 5/end-stage kidney disease will eventually receive kidney transplants. If a living related donor cannot be found, dialysis may be required until a donor kidney becomes available from the donor waiting list.