Nephrology Outcomes

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Why Choose Us: Nephrology

Our Outcomes: The Results of Our Care

Nemours pediatric nephrology (kidney care) physicians evaluate kidney (renal) function, help preserve kidney health, and treat kidney problems and diseases in kids. We can help manage children’s diet, medications, dialysis and kidney transplantation. Our nephrologists treat everything from recurring urinary tract infections to high blood pressure to permanent kidney damage caused by certain diseases that may require dialysis or a kidney transplant.

Why Measuring Results Matters

To provide pediatric care that's among the safest and most effective, we track and measure our results. Why? So we can:

  • help you make decisions about your child’s care
  • be clear about our results
  • improve so we can consistently deliver better, safer care

Here are a couple outcomes we track and focus on to improve the experience for both you and your child.

 

Reducing Infections in the Kids We Treat

Reducing Infections in the Kids We Treat


Making Sure Children Don’t Get Catheter Infections During Dialysis

Catheters (long, thin, flexible tubes) are a common part of care for kids with kidney problems. Unfortunately, there’s always a small risk of infections from catheters. For children with kidney failure, catheters are used in dialysis, a medical treatment that can take over the job of filtering the blood until failing kidneys heal or are replaced with a donated kidney through a kidney transplant. There are two kinds of dialysis, both of which use catheters:

  • Hemodialysis filters blood outside the body using a machine that pulls blood from the body through a catheter and filters it. After the blood is cleaned by the filter, the machine pumps the blood back to the body through the same catheter.
  • Peritoneal dialysis happens inside the body and is usually done at home. This kind of dialysis uses a sterile bag which contains a specialized electrolyte solution (containing water, glucose, sodium and other important components) that’s delivered into the abdomen through a catheter, and uses the lining of the belly as a filter. Waste products and extra fluid are pulled from the lining of the belly into the cleaning solution. The solution is then drained out of the body through the catheter into a separate bag and thrown away.

At Nemours, we take every precaution to ensure that the kids we care for don’t get infections from catheters. The surgeons that place the catheters use standardized procedures that minimize infection risk. At each clinic visit, the dialysis nurse provider and, when available, the physician look at the catheter exit site. We educate patients that do dialysis at home about the proper technique for accessing the catheter. These same families are also required to take refresher classes to maintain good technique, and all families are given home care instructions to minimize skin infections.

 

Catheter-Associated Infections in Children on Dialysis

0 infections

Nemours hemodialysis patients

1.3 infections

National average (benchmark)

Data source: Data collected electronically, looking at the number of infections per 1,000 — or every 1,000 days patients were on dialysis — at Nemours/Alfred I. duPont Hospital for Children (Wilmington, Del.) and Nemours Children's Hospital (Orlando), 2017.
Benchmark: G. Georgiev, et al. Sepsis-Induced Thrombocytopenia: Early Prediction and Modifiable Mortality. Crit Care. 2011; 15 (Suppl 1): P442. Published online 2011 Mar 11. doi: 10.1186/cc9862.

Identifying Medication Issues Early

Identifying Medication Issues Early


Making Sure Medications Aren't Hurting Kids' Kidneys

Doctors may prescribe many medications, especially when children are sick. Unfortunately, medications have side effects — some are easy to see like rashes, but some are more subtle and may not appear until there’s organ damage. The kidneys are among the organs that are most vulnerable to some medications’ effects. And in children, when their kidneys are still growing, the effects of these medications could result in kidney failure or other issues (this is called, “nephrotoxicity”).

At Nemours, our nephrologists were part of a team of leading pediatric hospitals that began an organized program, through our electronic medical record, to identify early when medications might negatively affect the kidneys. Once we recognize a possible problem, our kidney team talks to your child’s doctor and suggests alternative medications or dose adjustments to reduce your child’s exposure to the medication (this is called, “nephrotoxic medication exposure”). Since this national program began, within Nemours we’ve seen a 46 percent reduction to the risk of our patients’ kidneys. That means we've cut patient exposure to three or more nephrotoxic medications by half. The program has become so successful that it will soon be adopted by other children’s hospitals nationally.

 

Exposure to Kidney-Damaging (Nephrotoxic) Medications

6.73 exposures to medications that could harm the kidneys*

Nemours nephrology patients, 2016

3.63 exposures to medications that could harm the kidneys*

Nemours nephrology patients, 2017

Data source: * Data collected electronically, looking at the number of nephrotoxic drug exposures per 1,000 patient days — or every 1,000 days patients who were not in an intensive care unit were exposed to potentially kidney-damaging drugs; Nemours/Alfred I. duPont Hospital for Children (Wilmington, Del.) and Nemours Children's Hospital (Orlando); 2016 and 2017.

Our Differentiators: What Sets Us Apart

Our Differentiators: What Sets Us Apart


Why Choose Nemours Nephrology

The care of children with kidney disease is much different than in adults. Not only are their bodies still growing and changing, but kids also have different social and emotional challenges that only a pediatric team can fully address. Here are just some of the reasons families choose Nemours for their children’s nephrology care:

  • Experienced, highly skilled nephrologists. Our physicians are board-certified to provide the highest level of medical care for simple to complex conditions.
  • Top children's hospital for kidney care. Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del., is recognized by U.S. News & World Report as one of the best children’s hospitals in the country for nephrology treatment and care.
  • Award-winning physicians. Year after year, many on our team are recognized in “Best Doctors in America®."
  • Collaborative, team approach to your child’s care. Our nephrologists work closely with multispecialty teams built around your child’s condition, including neonatologists, urologists, pediatric general surgeons or anyone else your child needs to see.
  • Care coordination and help every step of the way. We help you navigate your child’s care. And, if you see multiple specialists, we work together to coordinate appointments to make it as convenient as possible for your family.   
  • Award-winning electronic health record (EHR) system. We encourage our patients’ families to sign up and use MyNemours. The parent portal of our EHR gives you secure access to your child’s records and allows you to communicate by email with your provider(s). So you can immediately report a problem and make sure it gets noticed and noted in the system so someone can contact you right away.
  • Close, personalized care for families. We treat every child as our own, and include you in every decision because we recognize that you know your child best. We work together to tend to your child’s physical, emotional and social needs before and after dialysis or surgery.