Nephrology

• We are very experienced treating children with kidney disease. We manage kidney failure so children can have as normal a life as possible and delay the need for a transplant.
• For children who do need transplants, Seattle Children’s is 1 of the top 5 kidney transplant centers in the United States. Our patients have excellent outcomes.
• Seattle Children’s has the only dialysis unit in the region just for babies, children and teens. Dialysis removes waste and extra fluid from the blood when the kidneys do not work well.
• Dr. Joseph Flynn, our chief of Nephrology, helped develop the national clinical guidelines for treating high blood pressure in children. Our Pediatric Hypertension Program is the only one in the region dedicated to evaluating and treating children and teens with high blood pressure.
• Only a handful of clinics in the nation focus on diagnosing and treating babies, children and teens with autoimmune disease that affects the kidneys. At a single visit to our Autoimmune Kidney Disease Clinic, your child will see doctors specializing in rheumatology and nephrology.
• Our Renovascular Hypertension team is highly skilled in treating kids who have problems with blood vessels that affect their kidneys. Our kidney doctors, interventional radiologists, surgeons and nurses work together to give your child expert care in a compassionate, healing environment.
• Our Kidney Stones Clinic is the only program in Washington state that specializes in diagnosing and treating children and teens with kidney stones.

• Our doctors, nurses, social workers and dietitians work together to care for your whole child, not just their disease.
• Children don’t react to illness, injury, pain and medicine in the same way as adults. They need – and deserve – care designed just for them. We offer educational, social and emotional support that fits your child or teen’s needs.
• We provide the right treatment for your child at the right time, from birth until age 21.
• Care starts before birth if your baby is diagnosed by an ultrasound during pregnancy. Finding problems early in pregnancy gives you more time to make decisions and plan care. Learn how our Fetal Care and Treatment Center can help.
• Our follow-up care and support services include home dialysis training, summer camp for children with kidney disorders, a newsletter and special activities planned just for children and their families.

• We take time to explain your child’s condition and answer all your questions. We help you fully understand your treatment options and make choices that are right for your family.
• Our doctors, nurses, child life specialists and social workers help your child and your family through the challenges of your child’s condition. We connect you to community resources and support groups.
• At Seattle Children’s, we work with many children and families from around the Northwest and beyond. Whether you live nearby or far away, we can help with financial counseling, schooling, housing, transportation, interpreter services and spiritual care. Read about our services for patients and families.
• For your convenience, our doctors see patients at locations in Seattle, Bellevue, Everett, Federal Way, Olympia, the Tri-Cities and Wenatchee. See our locations and contact information.

• Dr. Joseph Flynn, our chief of Nephrology, does research on how high blood pressure affects the heart and other organs of children and adolescents. He looks for ways to prevent and manage hypertension so today’s kids don’t get heart and kidney disease as young adults.
• Research by pediatric kidney specialist Dr. Jodi Smith aims to extend the life of transplanted kidneys as long as possible. With funding from the National Institutes of Health (NIH), she has worked to develop steroid-free approaches to maintaining the health of transplanted kidneys.
• Dr. Sangeeta Hingorani studies the long-term effects of stem cell transplants on the kidneys of children, adolescents and adults. The goal is to prevent long-term kidney damage in patients who have had this lifesaving procedure.
• With NIH funding, pharmacist Hyacinth Wilson and transplant coordinator Marian Sinkey are finding ways to help teens take daily medicine to avoid rejection of transplanted kidneys.
• We take part in research studies of promising new medicines to treat high blood pressure in children.

Many conditions can cause blood to show up in urine. This is called hematuria (hee-muh-TOOR-ee-uh). Often these conditions do not lead to lasting problems. But because blood in urine may be a sign of serious kidney problems, children with hematuria should see a doctor.

A child has end-stage kidney disease if their kidneys no longer work well enough to keep them alive without help. Usually this means kidney function that is less than 15% of normal for a child’s size and weight. Without dialysis or a kidney transplant, end-stage kidney disease causes serious problems and leads to death. The condition is also called end-stage renal disease (ESRD). Read more.

Some kidney diseases happen because of problems with genes or chromosomes that are passed down from parent to child. These genetic diseases include polycystic kidney disease (PKD). In PKD, many fluid-filled cysts grow in the kidneys and limit how well they function.

Glomerulonephritis (gluh-mer-yuh-lo-nih-FRY-tus) and interstitial nephritis (in-ter-STIH-shul nih-FRY-tus) cause swelling and redness (inflammation) in parts of the kidney. This makes it harder for the kidney to separate wastes and extra fluid from the blood. It can cause swelling (edema), blood in the urine, high blood pressure and tiredness (fatigue). This can sometimes lead to lifelong (chronic) kidney disease.

Hemolytic uremic syndrome (hee-muh-LIH-tik u-REE-mik SIN-drome) causes sudden, short-term kidney failure in children. In severe cases, children need dialysis for a while. Most children recover without lasting damage. HUS most often occurs after an infection with the E. coli bacterium. Read more. (PDF)

High blood pressure is more common in adults, but children and teens also can develop it. If untreated, high blood pressure can damage many organs of the body over time. These include the heart, brain, kidneys and eyes. The normal range for blood pressure depends on your child’s sex, age and height. Read more about our Hypertension Clinic.

Kidney failure happens when the kidneys can no longer remove all of the wastes from the blood. Kidney failure can either be long-lasting (chronic) or sudden (acute). Chronic disease usually develops slowly. Your child may not show any symptoms until the kidneys can remove only a small amount of waste. Children with acute kidney failure sometimes need dialysis treatments until their kidneys begin to work again. Children with chronic kidney failure need regular dialysis or a kidney transplant. Read more.

Kidney stones form when solid materials in urine build up in the kidneys and urinary tract. Small stones can pass out of the body on their own. Large stones may cause problems. They can be very painful when they block the kidney or the tubes that carry urine from the kidneys to the bladder. Kidney stones are more common in adults, but children get them, too. We have the only program in Washington state focused on diagnosing and treating children and teens with kidney stones.

Nephrotic syndrome happens when large amounts of protein get into the urine, leaving low levels in the blood. Blood proteins act like a sponge, helping water to stay inside your child’s blood vessels. When protein gets into urine, not enough is left in the blood. Water moves into body tissues, causing them to swell.

Proteinuria (proh-teh-NYOOR-ee-uh) means that pee (urine) has more protein than usual. Most proteins are too big to go through the kidneys’ filters, so too much protein in urine may be a sign of a kidney problem.

Seattle Children’s Acute Kidney Injury Clinic screens patients at risk for kidney damage before they go home from the hospital. Kidneys may be harmed by:

• Certain medicines
• Low blood flow to the kidneys
• Infections
• Very high blood pressure
• Liver disorders

 Follow-up with the kidney doctor is very important because your child may not show any signs at first. Damaged kidneys are less able to clean the blood. This can lead to a buildup of waste and fluid in the body. “Acute injuries” means the kidneys are suddenly not able to work normally. Children are at higher risk if they have cancer, infections or heart problems, or had a surgery.

The caring providers in our Autoimmune Kidney Disease Clinic diagnose and treat babies, children and teens with autoimmune disease that affects the kidneys. At a single visit to our clinic, your child will see doctors specializing in rheumatology and nephrology. Read more.

If your child’s kidneys do not work normally, they may need dialysis to filter waste and extra fluids from their blood. Seattle Children’s has the only dialysis unit in the region just for babies, children and teens. We treat children who are staying overnight in the hospital and who come in for dialysis during the day. Our specialists can teach you how to perform dialysis at home safely and how to handle any problems that might come up. Read more.

Our Kidney Stones Clinic is the only program in Washington state to focus on diagnosing and treating children and teens with kidney stones. We help get rid of stones your child has now. We also work with you and your child to prevent new ones. Your child can be seen by their entire health team in the same room, at the same time, to get complete care. Our team includes a dietitian plus doctors and nurses with special training in treating the kidneys (nephrology) and the urinary tract (urology). Read more.

Seattle Children’s is 1 of the top 5 kidney transplant centers in the United States. For children and teens with kidney failure, we provide care before, during and after kidney transplant. Read more.

Seattle Children’s Pediatric Hypertension program is the only program in our region dedicated to evaluating and treating children and teens with high blood pressure. Read more.

Renovascular hypertension is high blood pressure due to narrowing of the arteries that carry blood to the kidneys (called renal artery stenosis). Our team of pediatric specialists are highly skilled in diagnosing and treating problems in blood vessels that affect the kidneys. Read more.