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.
Some of the kidney problems we evaluate include:
- hematuria: blood in the urine
- proteinuria: protein in the urine
- kidney stones
- urinary tract infections
- bedwetting: called 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: referred to as 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: 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
For Appointments: (302) 651-4200
- 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
- Patient Presents Without Legal Guardian (PDF)
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Note: A parent or legal guardian must be with a child for a first visit.
Resources for Patients & Families
The pediatric nephrology specialists (kidney specialists) at the Nemours/Alfred I. duPont Hospital for Children provide consultation, evaluation, and treatment for children with a wide range of kidney problems on an inpatient and outpatient basis. We provide a specialty clinic for hypertension (high blood pressure) and a multi-disciplinary renal clinic where several subspecialists are present at one time to offer their expertise for your child’s condition.
The Division participates in the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS), which uses a state-of-the-art clinical approach for the treatment of pediatric patients with end-stage renal disease.
What to Expect at a Visit
At your child’s first visit, we will 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.
Other services include:
- Perinatal testing and specialty consultations available for women carrying babies with congenital kidney abnormalities
- Nurse educators who make sure you understand how to manage your child’s condition at home
- A dietitian who can make nutritional recommendations
- A social worker to help you deal with your feelings
- Adolescents with kidney disease can share mutual concerns in regularly scheduled group meetings conducted by nephrology staff members and with teenage tutors, many of whom are patients themselves.
Kidney and Bladder Care Program
Kidney and urinary issues are frequently inter-related, especially in children. For this reason, we implemented our Kidney and Bladder Care Program, which is staffed by a pediatric nephrologist and a pediatric urologist. Together, they can better evaluate and treat young patients with problems involving both the kidney and bladder. Here, you and your child have access to coordinated care from both board-certified specialists at the same time, on the same day. This approach provides added convenience for you, and also provides enhanced treatment planning between your child's doctors, nurses and your family.
Kidney and bladder care conditions we treat include:
- voiding dysfunction (when the bladder doesn’t empty normally, causing too-frequent urination, daytime accidents and/or nighttime bedwetting)
- congenital anomalies of the kidney and/or urinary tract
- hematuria (blood in the urine)
- obstructive uropathy (when urine can’t drain through a ureter — the tube that carries urine from the kidneys to the bladder — backing urine up into the kidney and causing it to become swollen)
- kidney stones
- bone and mineral disorders
- chronic kidney disease
End-Stage Renal Disease Program
For children with 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 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: Nearly all children with end-stage kidney disease eventually receive transplants. If a living related donor can't be found, dialysis may be required until a donor kidney becomes available.