This year, two specialties placed among the top 25 nationwide: Nephrology at #14, and Neurology and Neurosurgery at #23. 

Additionally, for the second consecutive year, Children’s Mercy’s Pediatric and Adolescent Behavioral Health was named a top 50 program. (All mental health programs receive equal recognition.)  

The rankings below reflect the expertise, compassion and commitment the teams provide to patients and families every day. 

Children’s Mercy specialties’ rankings: 

• Nephrology (#14)
• Neurology & Neurosurgery (#23)
• Urology (#26)
• Cardiology & Heart Surgery (#30)
• Gastroenterology & GI Surgery (#33)
• Diabetes & Endocrinology (#36)
• Neonatology (#40)
• Pulmonology & Lung Surgery (#46)
• Behavioral Health (Top 50) 

“At Children’s Mercy, excellence isn’t defined just by rankings—every child we care for, every family we support and every breakthrough we achieve reflects the heart of our mission,” said Alejandro Quiroga, MD, MBA, President and CEO of Children’s Mercy. “Being recognized among the top pediatric hospitals in the nation by U.S. News & World Report is an honor, but what matters most is the trust families place in us and the healing we deliver every day. That’s the true measure of our success.” 

U.S News surveyed nearly 150 pediatric centers, gathering clinical and operational data. This data was then combined with results from a reputational survey in which board-certified pediatric specialists were asked where they would send the sickest children in their specialty. 

The full rankings and methodology are available at www.usnews.com/childrenshospitals. 

During the National Kidney Foundation (NKF) Spring Clinical Meetings 2025 (SCM25), Bradley Warady, MD, received the David M. Hume Award in recognition of his scholarship and humanitarianism. Dr. Warady is the McLaughlin Family Endowed Chair in Nephrology and a professor of pediatrics at the University of Missouri–Kansas City School of Medicine and serves as director of Nephrology and Dialysis and Transplantation at Children’s Mercy Kansas City.

In addition, he is a principal investigator of the Chronic Kidney Disease in Children (CKiD) study and among the lead faculty of the Standardizing Care to Improve Outcomes in Pediatric ESRD (SCOPE) collaborative, which aims to minimize infection-related complications in pediatric patients undergoing dialysis. In short, his career has been dedicated to children with kidney disease.

Nephrology Times spoke with Dr. Warady at SCM25 ahead of his acceptance of the award.

See the full interview via Nephrology Times

Children's Mercy Division of Pediatric Nephrology

The National Kidney Foundation (NKF) has awarded Bradley A. Warady, MD, the McLaughlin Family Endowed Chair in Nephrology, Professor of Pediatrics at the University of Missouri-Kansas City School of Medicine and Director, Division of Nephrology at Children’s Mercy Kansas City, with the David M. Hume Memorial Award. The distinguished honor will be presented at the NKF 2025 Spring Clinical Meetings in Boston, April 9 -13.  

Each year NKF considers the work of hundreds of specialists in the field of nephrology and selects among them those who most exemplify the relentless efforts of the NKF to enhance the lives of patients,  work that is vital to the 35 million adults and the many children in the U.S. who are affected by chronic kidney disease (CKD) and the 1 in 3 people who are at risk.

The David M. Hume Award was created in memory of one of NKF’s most distinguished members. The Hume Award is the highest honor given to a distinguished scientist-clinician in the field of kidney and urologic diseases. It is bestowed upon an individual who exemplifies the high ideals of scholarship and humanitarianism in an outstanding manner. 

Read the full press release via the National Kidney Foundation

Children's Mercy Division of Pediatric Nephrology

For the first time in more than a decade, this year’s rankings included a new specialty – Pediatric and Adolescent Behavioral Health. Children’s Mercy is featured as one of the top 50 programs in the country. All programs receive equal recognition in this inaugural year. This is a testament to all the work being done to address the mental health needs of children and teens in our community.

Six Children’s Mercy specialties rank among the top 25 nationally this year, with the Nephrology team ranking #9. The Neonatology team made a big jump to #11 up from #48 last year, and Cardiology and Heart Surgery jumped from #43 to #26.

Children’s Mercy specialties’ rankings:

·        Nephrology (#9)

·        Neonatology (#11)

·        Urology (#20 tie)

·        Gastroenterology & GI Surgery (#21 tie)

·        Neurology & Neurosurgery (#21)

·        Diabetes & Endocrinology (#23)

·        Cardiology & Heart Surgery (#26)

·        Pulmonology & Lung Surgery (#28)

·        Orthopedics (#35)

·        Cancer (#39)

·        Behavioral Health (Top 50)

“Being among the top pediatric hospitals nationally is worth celebrating,” said Paul Kempinski, MS, FACHE, president and CEO of Children’s Mercy Kansas City. “Children’s Mercy finished first in Missouri and tied for third place in the Midwest region, which includes more than 40 hospitals across 13 states. The rankings are a true testament to our team’s hard work, expertise and dedication to the patients and families we serve.”

In surveying nearly 200 pediatric centers, U.S. News gathered clinical and operation data. This data was then combined with results from a reputational survey in which board-certified pediatric specialists were asked where they would send the sickest children in their specialty.

Those pediatric specialties consist of: behavioral health; cancer; cardiology and heart surgery; diabetes and endocrinology; gastroenterology and GI surgery; neonatology; nephrology; neurology and neurosurgery; orthopedics, pulmonology and lung surgery and urology.   

The full rankings and methodology are available at www.usnews.com/childrenshospitals.

U.S. News surveyed nearly 300 pediatric hospitals. Three Children’s Mercy specialties rank among the top 20 nationally this year, with the Nephrology team ranked #10. The Diabetes & Endocrinology team tied for #15, and orthopedics made a big jump from #30 just one year ago to #18. 

 Children’s Mercy specialties’ rankings: 

• Cardiology & Heart Surgery (#43) 
• Diabetes & Endocrinology (#15) 
• Gastroenterology & GI Surgery (#27) 
• Neonatology (#48) 
• Nephrology/Kidney (#10) 
• Neurology & Neurosurgery (#30) 
• Orthopedics (#18) 
• Pulmonology & Lung Surgery (#33) 
• Urology (#26) 

“Being among the top pediatric hospitals nationally is worth celebrating,” said Paul Kempinski, MS, FACHE, president and CEO of Children’s Mercy. “Children’s Mercy finished first in Missouri and tied for seventh place in the Midwest region, which includes more than 40 hospitals across 13 states. The rankings are a true testament to our team’s expertise, high standards and dedication to the patients and families we serve.” 

In surveying the pediatric centers, U.S. News gathered clinical and operation data. This data was then combined with results from a reputational survey in which board-certified pediatric specialists were asked where they would send the sickest children in their specialty. 

Those pediatric specialties consist of: cancer; cardiology and heart surgery; diabetes and endocrinology; gastroenterology and GI surgery; neonatology; nephrology; neurology and neurosurgery; orthopedics; pulmonology and lung surgery and urology.    

The full rankings and methodology are available at www.usnews.com/childrenshospitals. 

In a Q&A, Bradley Warady, MD, pediatric nephrologist and researcher at Children’s Mercy Kansas City, discussed the rise in parental hesitancy toward vaccines, along with the effects this will have on public health.

Q: How has vaccine hesitancy affected vaccination rates in the past 2 years? What health outcomes will this lead to?

A: In 2019, the World Health Organization listed vaccine hesitancy as one of the top 10 threats to global health. Vaccine hesitancy has always been a concern, but it has become increasingly prevalent and has continued to rise across the United States, especially with the COVID-19 pandemic. The pandemic sparked conversation about vaccine hesitancy in general, and the low vaccination rates across the country reflect a highly visible increase in vaccine hesitancy. 

Research has shown that parents who reported hesitancy to other general childhood vaccines or influenza vaccines were also less likely to vaccinate their child against COVID-19. Information from a phone survey conducted in May 2022 showed that 33% of parents reported that they would not give their child the COVID-19 vaccine.

Vaccine hesitancy as it relates to childhood vaccines has been linked to significant outbreaks, so it is a public health priority to increase trust in vaccines. Failure to vaccinate places children at risk for otherwise preventable infections, and a variety of associated complications. Vaccine hesitancy and refusal is of particular concern for immunocompromised children, such as transplant recipients or those with cancer, who are at an increased risk for serious infection because of the medications they must receive. 

Q: How has social media contributed to the increase in vaccine hesitancy?

A: Social media facilitates the rapid spread of information. While it allows for the dissemination of useful and accurate information, it also allows for widespread misinformation regarding vaccine efficacy and safety, which has likely contributed to growing vaccine hesitancy and opposition. Thus, while there is overwhelming evidence that the COVID-19 vaccine is safe and effective, vaccine hesitancy persists.

Read the rest of the Q&A with Dr. Warady via Contemporary Pediatrics

COVID-19 vaccine information

COVID-19 Vaccine FAQ

A group of experts, patients and caregivers proposed recommendations to improve clinical care of pediatric patients with chronic kidney disease in a special report published in the American Journal of Kidney Disease.

“Although clinical guidelines and recommendations for the care of children with CKD exist, few incorporate the patient and parent perspectives on priorities and challenges,” Bradley A. Warady, MD, from the division of pediatric nephrology at Children’s Mercy Kansas City, and colleagues wrote. “Moreover, while such patient and family experience data are increasingly sought by regulatory agencies, they are rarely reported in combination with the perspectives of health care professionals.”

During a 1.5-day workshop in December of 2018, the National Kidney Foundation hosted 32 medical experts in pediatric nephrology and 10 parents and children/adolescent patients with CKD.

“The participation of patients and parents/caregivers living with childhood CKD in the workshop discussions added a novel dimension, experience-based relevance and credibility, and represents a key element to enhance the strength of the proposed recommendations,” Warady and colleagues wrote.

Read the full article via Healio

Kidney care at Children's Mercy

Researchers have figured out a way to safely give children a donor kidney without the need for immune-suppressing drugs -- an advance they hope to expand to many more kidney transplant patients in coming years.

Reporting in the June 15 issue of the New England Journal of Medicine, doctors at Stanford University describe the first three children to be treated with the new approach. It involved giving them not only a new kidney, but a new immune system -- both donated from a parent.

All three children now have normal kidney function, and are free of the anti-rejection drugs that transplant recipients normally have to take every day for the rest of their lives.

Much research remains before the approach can be widely offered, and experts cautioned that the three children in these cases had a rare genetic condition causing their kidney disease.

"This is a great outcome for these children," said Dr. Bradley Warady, director of pediatric nephrology at Children's Mercy Kansas City, in Missouri. "But we can't extrapolate this to all children who need a kidney transplant."

That caveat made, "there's cautious optimism this could become a more widespread procedure," said Warady, who is also on the board of directors for the National Kidney Foundation.

Read the full article via HealthDay

Pediatric Nephrology at Children's Mercy

Kidney Transplant

by Avery Osen

Whether it’s nighttime or nap time, some kids struggle with wetting the bed. It’s not always a reason to worry, but Catherine Woods, APRN, from Children’s Mercy Wichita is sharing tips to help stop bedwetting and what to do if parents are concerned.

View the full clip via Good Day Kansas

Learn more about Children’s Mercy Wichita

U.S. News surveyed nearly 200 pediatric hospitals. Seven Children’s Mercy specialties rank among the top 25 nationally this year, with the Nephrology team seeing its highest ranking at #4. Nine of our specialties finished higher than one year ago.

Children’s Mercy specialties’ rankings:

·       Nephrology/Kidney (#4)

·       Neonatology/Neonatal Care (#14)

·       Urology (#17)

·       Neurology & Neurosurgery (#18)

·       Cardiology & Heart Surgery (#19)

·       Diabetes & Endocrinology (#22)

·       Pulmonology/Respiratory Disorders (#24)

·       Gastroenterology/Digestive Disorders (#28)

·       Orthopedics (#30)

·       Cancer (#34)

“Being ranked in all 10 specialties is not an easy task, especially when considering the relentless stress that COVID-19 put on our organization last year,” said Paul Kempinski, MS, FACHE, president and CEO of Children’s Mercy. “To be among the top institutions in the nation speaks volumes about our expertise, outcomes and reputation, but also about our resiliency and resolve to provide the highest-quality care to our patients and their families, during even the most tumultuous of times.”

In surveying the pediatric centers, U.S. News gathered clinical and operation data. This data was then combined with results from a reputational survey in which board-certified pediatric specialists were asked where they would send the sickest children in their specialty.

Those pediatric specialties consist of: cancer; cardiology and heart surgery; diabetes and endocrinology; gastroenterology and digestive disorders; neonatology; nephrology; neurology and neurosurgery; orthopedics, pulmonology and respiratory disorders; and urology.   

The full rankings and methodology are available at www.usnews.com/childrenshospitals.

Tarak Srivastava, MD, FASN, has been named as a new member of the American Pediatric Society (APS), the first and most prestigious academic pediatric organization in North America. Dr. Srivastava and other new APS members will be recognized next April during the APS Presidential Primary PAS 2022 meeting in Denver.

Dr. Srivastava is a Professor of Pediatrics in the Section of Nephrology at Children's Mercy Kansas City. He started his career as a Nephrology fellow at Children's Mercy in July of 1997. His next love after patient care is translational research. He runs a National Institutes of Health (NIH)-funded Nephrology Research Laboratory, which is studying drugs to mitigate progression of chronic kidney disease in children. He is actively involved with various multicenter clinical research studies funded by the NIH to understand the disease process in children with Idiopathic Nephrotic Syndrome.

In 2016 Dr. Srivastava received an Academic Achievement Award as an appreciation for his work, and in February 2020 he was recognized as the “Shining Star” award winner for being the top-rated provider by Children's Mercy patients and families over the previous 12 months.

APS members are recognized child health leaders of extraordinary achievement who work together to shape the future of academic pediatrics. New members are nominated by current members through a process that recognizes individuals who have distinguished themselves as child health leaders, teachers, scholars, policymakers and/or clinicians.

“The APS mission is to shape the future of academic pediatrics through engagement of distinguished child health leaders to represent the full diversity of the field,” said APS President Mary Leonard, MD, MCSE. “Our new members represent the most distinguished and accomplished leaders in pediatrics whose outstanding work has advanced child and adolescent health and well-being in pursuit of this mission. I am honored to welcome this exceptional group of individuals to the APS and look forward to their active engagement with many exciting programs within the organization.

See the full list of new, APS members

Learn more about the Division of Pediatric Nephrology at Children's Mercy

Find information about the Children's Mercy Research Institute

Blood in your urine most often relates to a problem in your urinary tract, which includes your kidneys. Your kidneys are two bean-shaped organs that process waste from the body. Usually, the filters that are part of the kidneys block blood from entering your urine. When you have hematuria, these filters or another part of your urinary tract have leaked blood into the urine.

U.S. News surveyed nearly 200 pediatric hospitals this year. Five Children’s Mercy specialties rank among the top 30 nationally this year, with the Nephrology team leading the way at #10, the 11^th straight year to be in the top 10. The Children’s Mercy Cancer team, at #28, also improved its ranking for the fourth straight year, the longest streak since Children’s Mercy started participating in the survey in 2008.

Children’s Mercy specialties’ rankings, with one in the nation’s top 10:

• Nephrology (#10)
• Urology (#19)
• Cardiology & Heart Surgery (#24)
• Neurology & Neurosurgery (#25)
• Cancer (#28)
• Orthopedics (#31)
• Gastroenterology & GI Surgery (#32)
• Pulmonology & Lung Surgery (#37)
• Diabetes & Endocrinology (#38)

“These results speak volumes about our expertise, outcomes and reputation,” said Paul Kempinski, MS, FACHE, president and CEO of Children’s Mercy. “They are also a direct reflection on every Children’s Mercy employee and their commitment to our patients and their families, especially during a year that forever will be remembered for a devastating worldwide pandemic.”

In surveying the pediatric centers, U.S. News gathered clinical and operation data. This data was then combined with results from a reputational survey in which board-certified pediatric specialists were asked where they would send the sickest children in their specialty.

Those pediatric specialties consist of: cancer; cardiology and heart surgery; diabetes and endocrinology; gastroenterology and GI surgery; neonatology; nephrology; neurology and neurosurgery; orthopedics, pulmonology; and urology.

The full rankings and methodology are available at www.usnews.com/childrenshospitals.

Kaden Meiers is just 7-years-old and has gone without fully functioning kidneys since birth.

Now, he needs a kidney to stay alive---doctors found a match, in his dad.

“They usually start with the parents and family first to test and we tested and everything passed on me and so everything was clear and we did the crossmatch and it was good so I decided to do it for him,” said Kaden’s dad, Wayland Meiers.

To protect his health, Kaden stayed home from school and away from his friends this year.

But with his transplant days away, his classmates wanted to wish him well--

Friends and family made signs and marched around the school to show Kaden, he is still part of their tiger’s family.

See the full story via WIBW

Learn more about Nephrology at Children's Mercy 

“It’s well-known in pediatric nephrology that as these children reach adulthood, their veins are often worn out because of injury caused by repeated IVs and unavailable to serve as a vascular access for dialysis,” said Dr. Bradley Warady, Director, Division of Pediatric Nephrology. “This issue contributes to their long-term morbidity and mortality.”

To address this potentially life-threatening problem, Children’s Mercy implemented a unique quality improvement (QI) initiative in September, 2018 called “Save the Vein” to help preserve the veins of children with chronic kidney disease (CKD) and ESKD by preferentially using the dominant arm for lab draws and IV placement, while preserving the veins of the non-dominant arm.

“In the past, we just put IVs in the best vein available,” said Dr. Warady. “When we looked at the experience of our hospitalized patients with CKD/ESKD over a six month period prior to initiating “Save the Vein”, we found that it was 50-50 as to whether the IV was placed in the dominant arm. It became clear that there was no strategy to preserve veins and the perfect opportunity to approach this issue from a QI perspective.”

A multidisciplinary “Save the Vein” team was formed and was led by JoLynn Grimes, RN and Dr. Warady from Nephrology, with representatives from Nephrology, ED, PICU, Infusion team, Same Day Surgery, Operating Room, 5 Sutherland, Interventional Radiology, Vascular Access team (VAT), Pre-admission Testing and Child Life. Patients with advanced CKD had critical information notes placed in the electronic medical record to alert clinicians about the vein preservation strategies, and all hospitalized “Save the Vein” patients had a pink wristband placed on the non-dominant arm to indicate which arm should not be used for vascular access, if possible. Education regarding the initiative was also provided to clinicians throughout Children’s Mercy, in addition to patients and parents. Finally, audits of IV placement were conducted and reviewed by the “Save the Vein” team monthly.

“Children with chronic kidney disease typically require multiple IVs throughout their childhood as a result of their complex disease, so it’s important to institute a strategy to preserve veins in these children in case they need a fistula (an artery and vein surgically placed together for hemodialysis) when they’re older, says Dr. Warady”. What we're trying to do through our actions today is lessen the long-term medical burden for these kids, who ideally have a long life ahead of them”.

The two year results of “Save the Vein”, which were presented at the Annual Dialysis Conference in early March by Ms. Grimes and which were recently published in the American Journal of Kidney Diseases and first authored by Nisha Singh, MD, are evidence of what can be achieved by a group of providers at Children’s Mercy who are passionate about improving an important aspect of patient care. Over the two years, the percentage of IVs placed in the dominant (preferred) arm increased from 47% to 93% for all targeted patients, and in those patients < 5 years, dominant arm placement increased from 25% to 94%. The VAT placed more than 1/3 of the IVs to make it possible to place the IV in the desired arm without any child experiencing more than 2 attempts at IV placement. The success of “Save the Vein” has resulted in many pediatric kidney programs across the nation now instituting a similar program

Dr. Warady says that while the focus of “Save the Vein” is on children with kidney disease, he can eventually see the program becoming a hospital-wide initiative about vein preservation.

“There’s a lot of other kids with chronic illnesses that are high-risk for vascular access related issues over their lifetime. And while we can’t change their disease, by paying attention to the sometime overlooked importance of vascular health, we can help make a significant difference in the long-term outcome of these children.”

Learn more about the Division of Pediatric Nephrology at Children's Mercy, one of the top-ranked kidney care programs in the nation.

According to an NKF press release, development of the tool, known as the Pediatric Kidney Failure Risk Calculator, was led by Bradley A. Warady, MD, who serves as chief of the division of nephrology and director of Dialysis and Transplantation at Children’s Mercy Kansas City. 

“I am pleased that the National Kidney Foundation is making the Pediatric Kidney Failure Risk Calculator widely available to health care professionals,” Warady said in the release. “It is extremely rewarding to see the efforts of all those involved in the CKiD study, investigators, and patients alike, result in the development of a clinical tool that makes possible the provision of important prognostic information that can be incorporated into and enhance the treatment plan for children and adolescents with chronic kidney disease and their families.”

The release stated that the calculator is available to all clinicians who treat children with kidney disease and can be found at kidney.org.

Read the full story via Healio

Learn more about Nephrology at Children's Mercy 

A quality improvement initiative resulted in increased frequency of peripheral IV placement in the dominant arm for hospitalized children with kidney disease.

According to the researchers, the improvements seen were partially due to education and increased awareness regarding the importance of vein preservation for this patient population.

“An arteriovenous fistula (AVF) in the non-dominant arm is the preferred access for hemodialysis (HD) patients,” Nisha S. Singh, MD, of the division of pediatric nephrology at Children’s Mercy Kansas City, and colleagues, wrote. 

Researchers compared data on PIV location for patients from 2017 to that following the initiative.

They found that, prior to implementation of the initiative, 47% of PIVs were placed in patients’ dominant arms; for children younger than 5 years only, 25% were placed in the dominant arm.

After the initiative, 93% of PIVs were placed in the dominant arm; for children younger than 5 years, 94% were now placed in the dominant arm.

Singh and colleagues concluded of the findings, adding “pediatric nephrology teams caring for children with CKD need to advocate for vessel preservation as part of everyday patient management."

Read the full story via Healio

Learn more about Nephrology at Children's Mercy

Today we’re visiting with Dr. Farhan Ali, a pediatric nephrologist with Children’s Mercy Wichita who is sharing about protein in the urine and why parents should know about it. Listen as Dr. Ali gives some tips for physical symptoms of proteinuria and what to do if you see it in your child.

View the full clip via Good Day Kansas

Learn more about Children’s Mercy Wichita

World Kindness Day started in 1998 and is aimed at promoting large and small acts of kindness. The Shonkwiler family of John, Erin and Caleb Shonkwiler understands kindness as the Liberty family seeks a live donor for Caleb, who is in need of a kidney.

Erin said when she created a website and shared details of Caleb’s life and medical issues, people from all over began to offer words of kindness, support and hope. The family also created a Facebook page available by searching “Caleb Needs a Kidney.”

Caleb, who marks his 12th birthday this month, and his family know the needed transplant will not be his last. At his age, due to the expectancy of how long transplanted organs are projected to last, there may be multiple transplants needed in his future. Despite this, the family remains optimistic about Caleb’s prognosis.

The Shonkwilers knew a donor situation would be part of Caleb’s life early on in the child’s life. Erin said an early ultrasound registered urine backing up in his kidneys. A pediatric nephrology specialist, Douglas Blowey at Children’s Mercy Hospital in Kansas City, offered his medical expertise to the family.

If a living donor is found, Caleb's transplant will take place at Children's Mercy Hospital in Kansas City, but the evaluation and surgery for the donor will occur in the University of Kansas Health System.

Read the full story via News-Press Now

Learn more about Nephrology at Children's Mercy

Dr. Ali with Children’s Mercy Wichita talking with Good Day Kansas and sharing what to look for with kidney stones in children and teens, which is becoming more common with youth. Here are 3 tips for parents to help prevent kidney stones in children.

View the full clip via Good Day Kansas

Learn more about Children’s Mercy Wichita

Study results indicated that surveillance biopsies offer a safe way for health care providers to monitor pediatric kidney transplant recipients, allowing for the identification of modifiable pathologies such as subclinical rejection.

“We have been conducting surveillance biopsies for a number of years and wanted to evaluate the risk-benefit ratio of the procedure so that we could properly inform patients and families,” Bradley A. Warady, MD, of the division of pediatric nephrology at Children’s Mercy Kansas City told Healio Nephrology. “This study provides evidence to clinicians caring for pediatric kidney transplant patients on the safety and value of the procedure.”

The safety of the procedure was determined by complications that occurred within 3 months of each surveillance biopsy (major complications included formation of AV fistulas, loss of allograft, infection, intestinal perforation and death; minor complications consisted of “anything that prolonged hospitalization beyond the post-procedural observational stay, including macroscopic hematuria, self-limited perinephric hematomas, transient fever and pain associated with the procedure”).

“Parents and patients have readily accepted performance of the procedure as they recognize that the results of the surveillance biopsy may positively impact the management of their child’s transplant, and the procedure itself is safe with only rare, minor complications,” Warady said.

He noted that researchers from his institution will continue to collect information on the outcomes of these biopsies, while evaluating the impact of the procedure and the subsequent modifications of therapy on long-term transplant outcomes.

Read the full story via Healio

Learn more about Nephrology at Children's Mercy 

When children experience urinary tract infections and other kidney issues, the pediatric nephrology team at Children’s Mercy Wichita is local and provides excellent care right here in our own community. Dr. Ali is sharing just some of the services and benefits provided to families in southeast Kansas with Good Day Kansas.

View the full clip via Good Day Kansas

Learn more about Children’s Mercy Wichita

Children’s Mercy specialties’ rankings, with one in the nation’s top 10:

• Nephrology (#10)
• Urology (#21)
• Cardiology & Heart Surgery (#23)
• Neurology & Neurosurgery (#26)
• Orthopedics (#28)
• Cancer (#29)
• Gastroenterology & GI Surgery (#31)
• Pulmonology (#35)
• Diabetes & Endocrine Disorders (#43)
• Neonatal Care (#46)

“Having all 10 specialties ranked for the sixth year is a remarkable achievement when considering only about two dozen children’s hospitals rank in all 10 specialties each year,” said Paul Kempinski, MS, FACHE, president and CEO of Children’s Mercy. “The excellent care given by our entire team is keeping families closer to the communities in which they live and providing a sense of comfort and familiarity, and I think that contributes to the treatment and healing process."

This year, U.S. News surveyed nearly 200 pediatric centers to gather clinical and operational data. This data was then combined with results from a reputational survey in which board-certified pediatric specialists representing the 10 areas were asked where they would send the sickest children in their specialty.

Those pediatric specialties consist of: cancer; cardiology and heart surgery; diabetes and endocrinology; gastroenterology and GI surgery; neonatology; nephrology; neurology and neurosurgery; orthopedics, pulmonology; and urology.

The full rankings and methodology are available at www.usnews.com/childrenshospitals.

About Children’s Mercy Kansas City

Founded in 1897, Children’s Mercy is one of the nation’s top pediatric medical centers. With not-for-profit hospitals in Missouri and Kansas, and numerous specialty clinics in both states, Children’s Mercy provides the highest level of care for children from birth through the age of 21. U.S. News & World Report has repeatedly ranked Children’s Mercy as one of “America's Best Children's Hospitals.” For the fourth time in a row, Children’s Mercy has achieved Magnet nursing designation, awarded to only about 8 percent of all hospitals nationally, for excellence in quality care. Its faculty of more than 800 pediatric subspecialists and researchers across more than 40 subspecialties are actively involved in clinical care, pediatric research, and educating the next generation of pediatric subspecialists. Thanks to generous philanthropic and volunteer support, Children’s Mercy provides medical care to every child who passes through its doors, regardless of a family’s ability to pay. For more information about Children’s Mercy and its research, visit childrensmercy.org. For breaking news and videos, follow us on Twitter, YouTube and Facebook.

Nephrologists from around the globe — and primarily from China as this is where the virus originated — have developed a set of recommendations for the care of pediatric patients undergoing either in-center or home dialysis during the COVID-19 pandemic.

The guidance, recently published in Pediatric Nephrology, is based on “epidemiological features” of the severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2 virus] and COVID-19 disease.

Bradley A. Warady, MD, of the division of pediatric nephrology at Children’s Mercy Kansas City, told Healio Nephrology the recommendations are based upon the clinical experience in China and are similar to those which have been released for adult patients.

He said the recommendations are “directed at both the patients and the parents of these children, in addition to the in-center [hemodialysis] HD staff.”

Prefacing the guidelines, the researchers suggested several factors that may increase likelihood for pediatric patients developing the virus. These factors are especially relevant to those receiving in-center hemodialysis and include:

• compromised immune system (which can be “the result of long-term malnutrition, uremia, and/or immunosuppressants”);

• close proximity to other patients;

• frequent contact with health care workers, “who may be asymptomatic but infected while caring for a variety of other patients”; and

• presence of parents or other relatives during the treatment.

The researchers also emphasized the “proper and constant use” of personal protective equipment (PPE) by dialysis staff.

The researchers wrote that continually providing updated information, as well as providing education on preventive measures, is equally important for staff, patients and caregivers.

The researchers expect additional recommendations will be released from agencies, such as the CDC, that are specifically tailored to patients receiving dialysis in the United States.

Read the full story via Healio

Learn more about Nephrology at Children's Mercy

Higher levels of a circulating biomarker were associated with shorter time to kidney replacement therapy and lowering of eGFR in pediatric patients with chronic kidney disease, according to study results.

“I think it is remarkable that we have confirmed findings from recent adult studies demonstrating that [soluble urokinase plasminogen activator receptor] suPAR is a new potential biomarker for kidney progression in children,” Darcy K. Weidemann, MD, MHS, a pediatric nephrologist at Children’s Mercy Kansas City, told Healio Nephrology. “It is notable that the results are confirmed in a pediatric study, where the etiology of CKD is different from that of adults.”

According to Weidemann, suPAR may be especially useful in the earliest stages of kidney disease, “where our current biomarkers, like serum creatinine, are the most inadequate.” This would allow the highest risk patients to be identified “before it’s too late.” Therefore, she suggested the utility of this biomarker also be tested in children with mildly impaired kidney function, as well as in those with normal kidney function who are at high risk for the development of kidney disease, so diagnosis and treatment can occur as early as possible.

“We desperately need additional biomarkers to predict which patients are at most risk for progression so we can potentially intervene on these patients sooner, as well as adequately prepare our patients and their families for the prognosis of a potentially grave, life-long chronic illness,” she added. “Our ultimate goal would be to find molecular targets upon which we can design targeted drug therapy to halt the progression of CKD.” 

Read the full story via Healio

Learn more about Nephrology at Children's Mercy

Higher levels of a signaling glycoprotein were associated with acute kidney injury in patients who underwent coronary angiography or cardiac surgery, according to study results.

In a press release, primary investigator Salim S. Hayek, MD, of the University of Michigan, said, “[Soluble urokinase plasminogen activator receptor] suPAR reflects a process that physicians are unable to account for in traditional assessments of kidney disease. We believe this protein acts as the link between inflammation and kidney disease, both chronic and acute.”

Writing that AKI most commonly occurs in critically ill patients or in those with cardiovascular disease — as members of these populations are at increased risk due to older age, coexisting conditions and greater likelihood of undergoing medical procedures that affect the kidneys — Hayek and colleagues wanted to explore new therapeutic targets that could be used in preventive strategies.

The new findings from Hayek et al lead to the growing body of evidence surrounding the predictive ability of soluble urokinase plasminogen activator receptor (suPAR) and kidney disease, although this particular study further investigates the understudied relationship between suPAR and acute kidney injury. Previous studies by this group and others have shown an association between the prognostic ability of suPAR to predict the development of incident chronic kidney disease, and also is associated with more rapid progression of CKD. In this study, the authors found that higher suPAR levels were consistently associated with increased risk for subsequent AKI events in three different cohorts of high-risk adult patients undergoing coronary angiography, cardiac surgery and adults in intensive care unit with critical illness.

What is perhaps most notable about this tantalizing study is the early experimental evidence using a targeted monoclonal antibody that may one day serve as a possible therapeutic target. This is sorely needed in the current era of stagnant research progress in the field of AKI, which has mainly shown disappointing potential therapeutic interventions such as acetylcysteine, sodium bicarbonate and saline hydration. This important work also adds novel insights into the growing awareness of the continuum of acute kidney injury to chronic kidney disease.

Read the full story via Healio

Learn more about Nephrology at Children's Mercy

Higher levels of a circulating biomarker were associated with shorter time to kidney replacement therapy and lowering of eGFR in pediatric patients with chronic kidney disease, according to study results.

“I think it is remarkable that we have confirmed findings from recent adult studies demonstrating that [soluble urokinase plasminogen activator receptor] suPAR is a new potential biomarker for kidney progression in children,” Darcy K. Weidemann, MD, MHS, a pediatric nephrologist at Children’s Mercy Kansas City, told Healio Nephrology. “It is notable that the results are confirmed in a pediatric study, where the etiology of CKD is different from that of adults.”

Weidemann emphasized the lack of modifiable risk factors which can delay CKD progression as a point of concern, arguing that what physicians currently offer to patients is “limited” (mostly consisting of, she said, aggressive blood pressure and proteinuria control).

“We desperately need additional biomarkers to predict which patients are at most risk for progression so we can potentially intervene on these patients sooner, as well as adequately prepare our patients and their families for the prognosis of a potentially grave, life-long chronic illness,” she added. “Our ultimate goal would be to find molecular targets upon which we can design targeted drug therapy to halt the progression of CKD.”

Read the full story via Healio

Learn more about Nephrology at Children's Mercy

October 14 is a date James Sheldon will always remember. It was the day he felt good for the first time in 20 years. On that day, Sheldon received a kidney transplant and his life changed forever.

"Symptoms I’ve had for 20 years were gone the day I got my kidney,” Sheldon said. While Sheldon has had health issues for 20 years, he was just diagnosed with a polycystic kidney two and a half years ago. The ailment runs in his family. His grandmother, two aunts and one uncle all died from the disease. Sheldon received his new kidney from a living donor at the University of Kansas Medical Center in Kansas City. Finding the donor was nothing short of a miracle.

Sheldon, who is on the Pratt Police force, was in a kidney chain, one of 30 at the medical center, and his chain was extraordinary. His wife Beth tried to donate her kidney but it wasn’t a match. A woman named Cara decided she wanted to donate a kidney and went through the living donor program at the KU Med Center. A little boy, Wiley, was born with two bad kidneys and had been on a feeding tube all his life. Doctors struggled to keep him alive long enough to get a kidney.A man named Mark West wanted to donate a kidney to Wiley but was not a match. That’s where Cara stepped in and her kidney was a perfect match for Wiley. Then West found out his kidney was a perfect match for Sheldon.

Children’s Mercy worked with the KU Med Center to make the transplant happen.

Read the full story via the Pratt Tribune

Learn more about the Kidney Transplant Program at Children's Mercy

The flow of urine through the body is supposed to move in one direction only, starting at the kidneys and moving south through the rest of the urinary tract. But sometimes urine flow reverses and backs up to the kidneys. This reflux into the kidneys – technically known as vesicoureteral reflux or VUR – can be diagnosed at any age, but is typically caught in our earliest years. Research suggests that about 2% of all girls and 0.6% of all boys have kidney reflux.

Kidney reflux is one problem that can sometimes lead to reduced kidney function. Kidney reflux is classified into two categories.

No matter what causes kidney reflux, it can occur on just one side of the urinary tract (involving one ureter and one kidney) or on both sides of the urinary tract (involving both kidneys and both ureters).

Complications

The issue of kidney reflux isn’t the act of the urine yo-yoing up and down between the kidneys and the bladder; that part is painless, and most people don’t know that the reflux is occurring. The problem is that kidney reflux makes it easier for bacteria to grow in the urinary tract, greatly increasing the risk for repeat urinary tract infections. A lower urinary tract infection can involve the bladder and urethra; an upper urinary tract infection can involve the ureters and kidneys.

“In a normal adult or child, a (lower) urinary tract infection is pretty benign. But if the infected urine refluxes up into the kidney, you can develop a kidney infection, which is a lot more serious,” says Dr. Nathan Beins, a pediatric nephrologist at Children’s Mercy Kansas City in Missouri.

Kidney infections have two main risks:

• Scarring and decreased kidney function. “One little area might get scarred with the first infection and increase the risk for chronic kidney disease. After two infections or more, you might have changes in kidney function that will last the rest of your life,” Beins says. “We don’t know how many infections you have to get before you could develop kidney scarring.”
• Sepsis. When bacteria from a kidney infection (or any infection) leaks into the blood, the body fights back by releasing chemicals into the blood. But the chemicals can cause a chain reaction that lead to tissue damage, organ failure and death.

For many children, simply growing and getting bigger is enough to resolve kidney reflux. “If you have low-grade reflux, 80% of kids outgrow it. If it’s higher-grade reflux, it’s around 20% to 40% who outgrow it,” Beins says.

Read the full story via U.S. News & World Report

Learn more about Nephrology at Children's Mercy 

Children with chronic kidney disease face a higher risk for experiencing neurocognitive deficits. To examine whether sleep problems or fatigue may play a role, Rebecca Johnson, PhD, of Children’s Mercy Kansas City, and her colleagues examined clinical trial data related to fatigue, sleep disturbance, low energy, and trouble sleeping in 1,030 children with mild-to-moderate chronic kidney disease.

Among the children in the study, 26% experienced fatigue, 30% reported sleep disturbances, 39% experienced trouble sleeping, and 52% had low energy.

Fatigue and sleep problems are prevalent among children with chronic kidney disease and may affect neurocognitive and emotional-behavioral functioning,” says Johnson in a release. “Assessment of sleep problems and fatigue, interventions to improve sleep, and treating medical comorbidities may promote more positive emotional-behavioral and neurocognitive outcomes for children with chronic kidney disease.”

Read the full story via Sleep Review

Learn more about Nephrology at Children's Mercy 

After a year and a half on a waiting list, Gage Schneider, 17, learned he would get a donor kidney. The transplant was performed at Children's Mercy Hospital three weeks ago, and it was a success.

"We were so excited. We were over the moon," Gage Schneider's mom, Michelle Schneider said.

But just days after coming home, everything changed. Gage Schneider was running a high fever and his blood counts were dropping. Doctors' first concern was that Gage Schneider was rejecting his new kidney. A biopsy ruled that out. As the teen's health deteriorated, a team of specialists at Children's Mercy moved fast trying to figure it out.

"It was something we call ehrlichia chaffeensis. It's a bacteria that comes from ticks that often live in Missouri," Dr. Dwight Yin said.

Gage Schneider lives in a wooded area and was somehow bitten by a tick, possibly when he was outside with his dogs after the transplant.

"He's going to have a full recovery and do great things," Michelle Schneider said.

Doctors at Children's Mercy Hospital are submitting the case to the medical journals to help alert other doctors.

See the full story via KMBC 9

Learn more about Nephrology at Children's Mercy

Season 3 of Inside Pediatrics featured Jack's story.

Jack was not thriving after birth and was eventually referred to Children's Mercy where he received a kidney transplant from his father following a course of peritoneal dialysis. 

One year after transplant, KMBC 9 recently caught up with Jack's family.

See the full story via KMBC 9

Learn more about Nephrology at Children's Mercy

Watch episodes of Inside Pediatrics

KANSAS CITY, Mo., June 18, 2019 – Children’s Mercy Kansas City is once again recognized as one of the nation’s top pediatric hospitals, according to U.S. News & World Report’s 2019-2020 “Best Children’s Hospitals” report. For the fifth year in a row, Children’s Mercy is listed with the best in the country in 10 out of 10 pediatric specialties included in the survey. Children’s Mercy is among an elite handful of pediatric hospitals which consistently rank in all 10 specialties.

Children’s Mercy specialties in the top 30 rankings, with three in the top 15:

• Nephrology/Kidney (#7)
• Neonatology/Neonatal Care (#13)
• Orthopedics (#13)
• Urology (#17)
• Cardiology and Heart Surgery (#20)
• Gastroenterology/Digestive Disorders (#22)
• Neurology/Neurosurgery (#23)
• Pulmonology (#27)
• Endocrinology (#29)
• Cancer (#30)

“Five of our specialties made gains this year, including our Neonatology team which rose nearly 30 spots,” said Paul Kempinski, MS, FACHE, president and CEO of Children’s Mercy. “Having all 10 specialties ranked for the fifth year is testament not just to our team’s expertise, but equally important, it speaks to our partnership with our patient families and our community providers. It takes us all working together to ensure the best outcome for every child.”

This year, U.S. News surveyed more than 180 pediatric centers to gather clinical and operational data. This data was then combined with results from a reputational survey in which board-certified pediatric specialists representing the 10 areas were asked where they would send the sickest children in their specialty.

Those pediatric specialties include: cancer, cardiology, diabetes and endocrinology, gastroenterology, neonatology, nephrology, neurology and neurosurgery, orthopedics, pulmonology and urology.

The full rankings and methodology are available at www.usnews.com/childrenshospitals.

About Children’s Mercy Kansas City

Founded in 1897, Children’s Mercy is one of the nation’s top pediatric medical centers. With not-for-profit hospitals in Missouri and Kansas, and numerous specialty clinics in both states, Children’s Mercy provides the highest level of care for children from birth through the age of 21. U.S. News & World Report has repeatedly ranked Children’s Mercy as one of “America's Best Children's Hospitals.” For the fourth time in a row, Children’s Mercy has achieved Magnet nursing designation, awarded to only about 8 percent of all hospitals nationally, for excellence in quality care. Its faculty of more than 700 pediatric subspecialists and researchers across more than 40 subspecialties are actively involved in clinical care, pediatric research, and educating the next generation of pediatric subspecialists. Thanks to generous philanthropic and volunteer support, Children’s Mercy provides medical care to every child who passes through its doors, regardless of a family’s ability to pay. For more information about Children’s Mercy and its research, visit childrensmercy.org. For breaking news and videos, follow us on Twitter, YouTube and Facebook.

We asked, Dr. Bradley Warady, Division Director of Pediatric Nephrology, and Director of Dialysis and Transplantation, what it means to be ranked and why ranking matters when it comes to your child’s care.

How are U.S. News & World Report rankings determined?

Dr. Warady: U.S. News & World Report sends out surveys for different specialties to hospitals across the U.S. In the case of my specialty, it would be pediatric nephrology. Rankings are determined by key clinical data such as patient outcomes, infection prevention and resources at the institution. In addition, part of the hospital’s score is derived from peer input about which programs pediatric nephrologists believe are the best programs in the nation.

Why should parents care about rankings?

Dr. Warady: Children with end-stage kidney disease and the need for dialysis or a kidney transplant tend to be extremely complex patients, and centers that are ranked high have excellent patient outcomes, which is most important to parents. We have a 100% successful transplant rate and our dialysis program has one of the lowest infection rates in the country.

Of course, this isn’t to say that centers not ranked in the top 10 or top 20 can’t provide good care for children on dialysis, with a transplant or with other kidney disorders, because they can. However, the top-ranked programs are proven centers of excellence and have the resources necessary to achieve the best patient outcomes.

In addition to pediatric nephrologists, top-ranked kidney programs will also have a multidisciplinary team comprised of surgeons, nurses, social workers, dieticians, pharmacologists, transplant coordinators, psychologists, child life specialists and education coordinators. In most cases, they are also actively involved in a variety of research activities.

Ranking isn’t everything, so what advice do you have for parents looking for a kidney program?

Dr. Warady: Number one, parents should look at the expertise the center provides with respect to the disorder for which their child will need treatment. If a child has kidney failure, parents should ask about outcomes regarding infection prevention, as well as dialysis and transplant outcomes. They should find out how many transplants have been performed at the center, and most importantly, how long those transplants are lasting.

If, on the other hand, the child has a different kidney related disorder such as metabolic bone disease, recurrent urinary tract infections, high blood pressure or bedwetting, the parent should seek out information regarding the expertise of the physicians and staff in the program in caring for these disorders. A program that has the capacity to successfully address all of these and other kidney issues will best meet the needs of the patients and their families.

They should also make sure the center has a well-established transition program. Transition education is critical for children as they become a young adult, so they can develop the skills necessary to manage their condition when they move from pediatric to adult kidney care. We have one of the most developed nephrology transition programs in the county and we closely collaborate with our adult counterparts to best determine what these children need to know before moving to adult care. As part of this collaboration, and to complement our transition education curriculum, we recently initiated a transition readiness checklist that is completed by children that we care for every year starting at 12 years of age. This serves as a blueprint for what the child needs to know about their medical management, so they are prepared to transfer to adult care by 22 years of age.

Lastly, parents should find a center that focuses on family-centered care.

Why is family-centered care important?

Dr. Warady: The family-centered approach permeates throughout our division of nephrology. We recognize that a partnership must exist between families and health care providers if we are to provide the best, and most practical approach to care.

Families need to be part of the care team. It simply doesn’t work if a doctor recommends a plan that’s not practical to implement in the home situation. In most cases, parents know what they can do and what the child can do, so we need to work together on what works best for that particular patient and family to get the best outcome.

Our parents play a key role in our success. Every year when the rankings come out, I meet with the patients and families of children on dialysis or with a kidney transplant to say thank you, because the rankings are in large part based on outcomes. The Children’s Mercy kidney program wouldn't be able to achieve the great outcomes that we have achieved if the kids and families weren’t so supportive of our efforts by carrying out the recommendations that we have developed together.

As health care providers, we make recommendations of care, but the management is carried out by the patients and families; and that partnership is what excellent pediatric care is all about.

What does it mean for this program to be continuously ranked year-after-year?

Dr. Warady: I believe that what’s most important about the ranking is the affirmation that our kidney program and our hospital is doing a great job caring for the kids and families that look to us for help. The faculty and staff work extremely hard to achieve the best possible outcomes for these kids. Of course, the rankings also serve as a stimulus to improve and not rest on our laurels. We have set the bar high for ourselves in terms of expectations and we continuously try to exceed what we have achieved in years past.

Any other advice for families looking for a kidney program?

Dr. Warady: Families should know they have the opportunity to speak with us or visit with us before committing to the care we provide. We encourage families to “test us out.” You kick the tires before you purchase a car and you should have the same opportunity with your health care provider, and we welcome that.

Learn more about the Nephrology Program at Children’s Mercy.

Learn more about the Kidney Transplant Program at Children’s Mercy, the largest pediatric transplant program in Missouri and Kansas.

Learn more about the Dialysis Program at Children’s Mercy.

Read Dr. Warady’s blog “The Doctor-Patient Relationship: How it Impacts Your Care.”

What causes kidney stones?

Dr. Alon: The most common kidney stones in children are composed of calcium. There are two main reasons why a child might develop stones. The first is genetics. However, only 5% of children that develop kidney stones will have a genetic disorder.

The more prevalent cause that can increase the risk for kidney stones is environmental contributors such as nutrition, geographic location and fluid consumption.

Any salt that is consumed is absorbed in the body and finds its way into the urine. For simplicity, the salt basically drags calcium to the urine and too much calcium can cause hard deposits to develop.

Also, a hot work environment and/or dehydration can promote the development of kidney stones. For example, the Army noticed an increase in kidney stones in soldiers stationed in Iraq and the soldiers were told to drink more water. The incidence of kidney stones decreased significantly simply by drinking more liquids.

Why are more teenagers getting kidney stones?

Dr. Alon: We’ve definitely seen an increase in kidney stones over the last several years. Nationally, there’s been a 3-4 fold increase among teenagers. We’re seeing more cases partly because we have better diagnostic tools in the Emergency Room. Instead of a simple x-ray, we now get a CT of the patient’s abdomen, which is a much better tool to diagnosis kidney stones.

However, the bigger contributor to the increase in kidney stones is excess salt. For adults, the recommended sodium intake is a maximum of 2300 mg. Teenagers should consume much less and maximum consumption is based on the child’s size. For instance, if the teenager is half the size of an adult that teenager should only have half the recommended amount, which would be 1200-1400 mg.

Also just as important, teenagers are not eating enough fruits and vegetables, which contain potassium and counteracts sodium. It’s this imbalance in sodium and potassium that results in excess of calcium that triggers kidney stones.

Does eating more fruits and vegetables help prevent kidney stones?

Dr. Alon: Yes. If someone eats something salty, like pizza or a hot dog, and also eats a fruit or a vegetable with the meal the potassium will counter the effect of sodium. Think of sodium as the bad guy and potassium as the good guy. The good guy will be able to control the bad guy. Because of this, no food is off limits – you just have to have a good balance between the bad and good.

The average American teenager only consumes 1.5 servings of fruit and vegetables daily. The government recommendation is nine servings a day. We know this can be difficult to achieve, so we recommend at least five servings a day, which means there should be a fruit or vegetable at every meal.

We also highly recommend the Dietary Approaches to Stop Hypertension (DASH) diet. While the DASH diet was designed to control blood pressure, it also aims to reduce the amount of sodium and increase potassium in the diet.

You also mentioned the importance of hydration. What should teenagers be drinking?

Dr. Alon: Teenagers need to make sure they’re getting plenty of fluids. They can drink water, flavored water, tea and juice (just make sure the juice doesn’t contain too much sugar).

A misconception is that drinking too much milk can cause kidney stones. A recent study shows that nutritional calcium intake does not have an effect on kidney stones unless consumed in extreme amounts.

What are the symptoms of kidney stones and how do you treat it?

Dr. Alon: It depends on the age of the child. Young children may have general complaints of a tummy ache and sometimes throw up. Older children and adolescents will have pain in the flank, back or lower abdomen, and the pain will often be excruciating. In some cases, blood may be present in the urine.

Most of the time kidney stones will pass on their own. The pain will go away once passed. On average, it takes hours or days to pass a kidney stone. Medications can help dilate the urinary passage to help move the stone out of the system. If it’s too big or if it’s been longer than a week than an urologist will likely intervene to remove the stone. Kidney stones left untreated can deteriorate kidney function.

What is the best advice for preventing kidney stones?

Dr. Alon: Drink more fluids, eat healthy and pay attention to diet. A child that has developed kidney stones in the past is at greater risk for developing additional stones in the future. Preventative measures are key.

We also know that changing diet and habits can’t happen overnight and it’ll take a few weeks to make adjustments. We also know teenagers will follow recommendations for several months and then slowly go back to old habits. It’s not easy and it requires discipline. Support and encouragement are key to success.

Learn more about the Bone and Mineral Disorder Clinic at Children’s Mercy.

Learn more about the Division of Pediatric Nephrology at Children’s Mercy, which is one of the top five kidney care programs in the nation.

Cinacalcet is approved in Europe for treatment of secondary hyperparathyroidism (SHPT) in children aged 3 years and older on dialysis, but not in the United States. Now results from a new study suggest cinacalcet may meet “an unmet medical need for this population,” according to researchers.

“These data suggest that cinacalcet may meet an unmet medical need for the pediatric dialysis population,” Dr Warady's team concluded. “Due to the premature discontinuation of the trial, uncertainties remain regarding the long-term effects of cinacalcet on growth and development in the pediatric population, and close supervision and monitoring for hypocalcemia and its secondary effects is warranted.”

Read the full story via Medical Health News

Learn more about Pediatric Nephrology at Children's Mercy

“I was sick, and I didn’t know why,” Sarah says. “My parents never talked about it at home. I didn’t know about diet and nutrition. I was living in the dark. And, I was bullied a lot in school, especially when I was sick. It was such a different experience than being an adult kidney patient.”

Almost 10,000 children and adolescents in the U.S. are living with end-stage renal disease (ESRD). They are 30 times more likely to die than healthy children. 

At the first ever NKF Scientific Workshop on CKD in Children on Dec. 6 and 7 in Atlanta, dozens of professionals in pediatric nephrology, patients, and their parents will gather to use recent children-focused research, the needs inherent in stories like Sarah’s, and new ideas from the meeting participants to make recommendations that will improve the care for kids with the overwhelming disease.

Dr. Bradley A. Warady, MD, Director, Division of Nephrology, Children’s Mercy Kansas City and Professor of Pediatrics University of Missouri – Kansas City School of Medicine, and Dr. Susan Furth, MD, PhD, Director, Division of Nephrology, Children’s Hospital of Philadelphia and Professor of Pediatrics and Epidemiology Perelman School of Medicine at the University of Pennsylvania, will co-chair the conference.

“Well-controlled clinical trials in children with CKD are scarce, due to the small population and their exclusion from most therapeutic studies,” Warady says. “Therefore, recommendations for clinical care in pediatric nephrology are most often based on small trials and expert opinion, with the latter commonly the product of little published evidence. The time is right to make every effort to enhance the care of children with CKD.”

Read the full story via National Kidney Foundation

Learn more about Pediatric Nephrology at Children's Mercy

Christa Jordan had several reasons not to donate a kidney a few months ago.

She had just gotten married, and her husband was about to start graduate school. And her brother might need a kidney some day.

But the Children’s Mercy Hospital nurse had one very good reason to donate: a patient who also happened to be her friend needed a kidney, and she had one to give.

“I just knew it was something I had to do,” Jordan said. “It wasn’t something I questioned that much.”

Jordan’s decision triggered a series of events that led to three people getting new organs, as the University of Kansas Hospital and Children’s Mercy collaborated for the first time on a kidney donation chain.

Donation chains are still rare because of the amount of planning they take and also because they usually require at least one “altruistic donor” — a person who gives a kidney without knowing any of the recipients.

In the latest kidney chain, that was Ky Kanaman, a 25-year-old Baldwin City triathlete and businessman who, along with his wife, cares for adults with intellectual disabilities.

“I kind of looked at myself and said, ‘Well, I’ve got two and I’ve got plenty of ability to give one, I think,’” Kanaman said.

Kanaman was a match for Jordan’s friend, Dayshanae Hosman. Jordan was also a match, but not as good a match as Kanaman was. She was a better match for a person on KU’s list, Lauro Zuniga.

So Jordan agreed to give her kidney to Zuniga if Kanaman donated his kidney to Hosman. That meant that Zuniga’s mom, Carolina Perez, who wasn’t a match for her son, could give her kidney to another person on KU’s list: Matt Lewis.

“I feel like I won the lottery,” said Lewis, a 54-year-old from tiny Savonburg, in southeast Kansas.

Read the full story via The Kansas City Star

Watch a video explaining the transplant chain

Around the same time, a Baldwin City, Kan., triathlete with a huge heart was determined to donate one of his kidneys after learning about living kidney donation. When doctors at Children’s Mercy and The University of Kansas Health System realized the triathlete’s kidney was a similar match – if not better – for the longtime Children’s Mercy patient, and that the nurse could in turn donate to someone else, the “chain” reaction began.

One of the living donors matched a Wichita man who had been waiting four years on dialysis for a kidney. His mother was no match for him, but her kidney was perfect for a Savonburg, Kan., man on the waitlist for two years.

A total of six surgeries took place at Children’s Mercy and at The University of Kansas Health System on Monday, Oct. 29 and Tuesday, Oct. 30 – three to remove the living donors’ kidneys and three to implant the gift of life into their waiting recipients. Kidney chains traditionally begin with an altruistic donor willing to give their healthy kidney to someone in need – often a complete stranger. Through the thoughtful pairings of this chain, three people were able to get the gift of life instead of one. This was also the first time that a pediatric patient at Children’s Mercy was involved in a transplant chain.

“When we considered this opportunity, I spoke to the nephrologist at The University of Kansas Health System about the need to be assured that having our nurse Christa donate to a second person was not going to have a negative impact on Dayshanae in terms of the donor/recipient match. And so we had to look very, very closely at the match between the altruistic donor and Dayshanae, and Christa and the second recipient, and we found that the matches were favorable in both cases,” Bradley Warady, MD, Director of the Division of Pediatric Nephrology and Director of Dialysis and Transplantation at Children’s Mercy said.

“This was a wonderful collaboration between Children’s Mercy and the University of Kansas Health System. And because of that, future chains will likely occur for other kids followed in the Children’s Mercy End-Stage Kidney Disease program. Our philosophy is to do whatever we can do to expedite successful transplantation in our kids, and shorten their time on dialysis.”

“This event and collaboration with Children’s Mercy illustrates how creative transplant teams can get to make sure a living donor’s desire to help a friend, family or even a stranger is met,” Timothy Schmitt, MD, director of transplantation at The University of Kansas Hospital said.

“The gift of life donated by living donors is always inspiring,” Sean Kumer, MD, PhD, physician vice president of operatives services at The University of Kansas Hospital said. “While our transplant teams have the confidence to do what it takes to benefit our patients, none of this would have been possible without the selfless actions of the organ donors.”

“Living related kidney transplantation is still the best option today for providing long term kidney survival for our pediatric recipients, with half of these kidneys surviving more than 15 years. Unfortunately, a lot of children do not have access to a living donor because they do not have a suitable donor,” Walter Andrews, MD, surgeon at Children’s Mercy said.

“At Children’s Mercy we have several children who are very difficult matches for even a deceased kidney and paired donation provides them with hope that a compatible kidney can be found.”

That motivating factor led staff at both hospitals to do whatever was necessary to create this successful chain.

The structure of this six-patient chain looked like this.

At any given time, around 600,000 people are on dialysis and nearly 100,000 are on the waiting list for a kidney transplant. Yet fewer than 20,000 transplants were done in 2017, of which only 5,835 involved living donors.

Between the two hospitals, hundreds of patients are listed for a kidney transplant and anxiously await a kidney from a deceased donor. The collaboration on this living donor transplant chain and future chains which target the best matches between donors and recipients, will allow more patients – and specifically more pediatric patients – to get the lifesaving transplant they need in much less time.

And there’s yet another story as the perfect postscript: The nurse who wanted to donate her kidney to her friend but was willing to give it to a stranger also becomes the first recipient of the “Warady Benefit” at Children’s Mercy. Honoring Dr. Bradley Warady, who has championed organ donation throughout his career, the benefit will allow employees who become living donors to use up to 40 hours of additional Extended Illness Time as they recover from surgery.

EDITORS/PRODUCERS: Video interviews with patients and physicians as well as surgical broll are available for use by all news outlets and can be found here:

Children’s Mercy link

The University of Kansas Health System link

Nephrology Social Workers Cristina Hernandez, LCSW, LMSW and Kelli Scott, LCSW, LMSW, share an office in the kidney dialysis unit, and soon they also will share the distinction of winning a national award that has become something of a tradition for Nephrology social workers at Children’s Mercy.

Cristina recently was named the recipient of the National Kidney Foundation’s (NKF) 2019 Award for Social Work in a Pediatric Setting. Kelli won the NKF award last year, making it two years in a row for Children’s Mercy and the fourth time in history that a Children's Mercy Nephrology social worker has won the award. Bradley Warady, MD, Division Director-Pediatric Nephrology and Director of Dialysis and Transplantation, said it is unprecedented for the same hospital to win this prestigious NKF national award two years in a row, and four times total.

Nephrology Social Workers Kelli Scott (left) and Cristina Hernandez (right) won back-to-back "Awards for Social Work in a Pediatric Setting" from the National Kidney Foundation, making Children's Mercy the only institution to win the national award two years in an row and four times total.

Indispensable

“Cristina and Kelli are indispensable members of our dialysis and transplant team,” Dr. Warady said. “The fact that they are back-to-back recipients of the NKF award not only highlights their exceptional performance, but it also emphasizes how lucky we are to have them both at Children’s Mercy.”

Cristina will receive the award at the NKF 2019 spring meeting in Boston; Kelli was honored at the NKF’s 2018 spring meeting in Austin, Texas. Cristina was on hand for Kelli’s big day, and Kelli will be in Boston to cheer for her colleague and office-mate next spring in Boston.

Kelli and Cristina both provide social work services for dialysis and kidney transplant patients. They work closely with this patient population to provide ongoing psychosocial assessment and care coordination. Every day is a bit different for them: this often includes providing emotional support to the patient and families as they adjust to their diagnosis and start down the transplant path, which often includes dialysis. They work to connect patients with resources that may be able to benefit them. They provide in-depth education, ongoing support and advocacy related to many topics, including medication adherence, care planning and advance directives to name a few. Kelli and Cristina also work closely with patients and their families to ensure educational needs are being met and insurance issues are addressed. They are integral members of the medical team, so communication with the medical team is a key component of the work they do.

Both Cristina and Kelli attribute the success of nephrology social work at Children's Mercy to the support of the Nephology program and medical team.

“Our Children’s Mercy Nephrology program really values social work, and I don’t know that every Nephrology program has that,” Kelli said. “We get the opportunity to participate fully in the patient’s care, and our opinions are valued. I think they value our perspective and our advocacy for our patients because it’s helping them achieve their medical goals.”

Helping families adjust

Cristina said, “I would echo that; just to be valued, to be looked to as an expert in our field, helping families adjust to kidney disease. I think the medical staff appreciates that we remind them that this is more than a dialysis patient or kidney transplant patient…they have other stressors in their lives, and kidney disease is just one component of who they are.”

Those stressors, Kelli said, are often related to the fact that, “Many of our patients often don’t come from psychosocially stable families. Our families have so many other stressors in their lives that they’re just trying to work through daily, and then you add in dialysis or a transplant, it can be extremely difficult to manage.”

Life-changing disease

“It’s a difficult and invasive disease to adjust to, and incredibly life-changing,” Cristina said. “With dialysis, you could be here 14 hours a week, and when you add in all the other appointments involved, it’s almost like a part-time job; these kids are also going to school, may have a real part-time job and other family obligations. Getting their medical needs met involves a lot of complications and adversity to overcome.”

Kelli added, “And it’s often hard for patients to realize that transplant is just a treatment, not a cure; they’re most likely going to have to require another transplant in their life. So it’s not necessarily the end of dialysis.”

Cristina, who has been at Children’s Mercy for four years, has witnessed kidney disease first-hand in her family; her mother was a dialysis patient.“My mom was on dialysis, so this kind of work always had a special tug on my heart,” Cristina said. “I’ve been lucky in that having a family member on dialysis, I can see the other piece of it. It really helped me understand the journey a patient with kidney disease goes through. I was a child welfare social worker before I came here, and I’ve just always had a passion to work with kids and their families.”

Kelli, who has been at Children's Mercy for six years, has a cousin who had a kidney transplant, but she said that didn’t influence her decision to enter the field. She began her career in the mental health area, then became interested in obtaining her master’s degree in social work. She started in the GI Clinic at Children's Mercy, then moved to Nephrology social work when the opportunity arose.

“I enjoy working with families on an ongoing basis, and I just really like working with this population,” Kelli said. “I see myself being in this position for a long time.”

Congratulations to Cristina and Kelli for continuing a tradition of excellence at Children’s Mercy!

Learn more about the Division of Pediatric Nephrology at Children's Mercy.

“The registry will also help us answer a number of questions related to the long-term outcomes for patients and the long-term effects of cystinosis on the kidneys and all other organ systems.”

“Initial cystinosis natural history studies were conducted decades ago by the National Institutes of Health and there have been few studies since that time that track the progression of cystinosis,” said Bradley Warady, M.D., professor of pediatrics at the University of Missouri-Kansas City School of Medicine, director of pediatric nephrology at Children’s Mercy Kansas City and member of the NAPRTCS board of directors. “With recent advancements, people with cystinosis are living longer lives; however, our understanding of the disease in the context of these recent advancements and new treatments is limited. By gathering data from people living with cystinosis over an extended period of time, the NAPRTCS registry will provide key information for physicians and researchers.”

Read the full story via the Business Wire.

Learn more about Pediatric Nephrology at Children's Mercy

Children’s Mercy researcher Dr. Bradley Warady received another $5 million to continue a long-running study of chronic kidney disease in children.

On Aug. 24, the National Institutes of Health (NIH) awarded the grant to Warady, director of pediatric nephrology, who has led the study at Children's Mercy in conjunction with the Children’s Hospital of Philadelphia for 15 years.

The observational study, called CKiD, has been running since 2003 and includes 54 centers. It’s intended to track risk factors that can lead to the decline of kidney function and risk factors that can be associated with kidney disease, such as anemia and hypertension.

With the additional money, Warady and his team will be able to continue their research through 2023.

"It's crucial to the long-term outcome for these kids," Warady said in a previous interview. "Chronic kidney disease care has remarkably improved, in large part, because of data from CKiD."

Read the full story via Kansas City Business Journal

Learn more about Pediatric Nephrology at Children's Mercy

By Nathan Beins, MHPE, MD Pediatric Nephrology Children's Mercy Kansas City

One of the most common questions asked by parents of children with kidney disease is whether contact sports are safe. Physical activity is very important for overall health and this is especially true for children with kidney diseases. Chronic kidney disease (CKD) can increase the risk for heart disease and physical activity is important in preventing heart disease. Team sports and activities play a large role in encouraging kids to be physically active, especially during childhood. Because of the many benefits of physical activity, it should only be restricted when absolutely necessary.

Understandably, parents are worried about injuries to their child’s kidney. But, kidney injuries are actually very uncommon. In fact, most kidney injuries are minor and do not result in permanent loss of kidney function. Motor vehicle accidents are the most common cause of kidney injuries. The next most common cause of kidney injuries are horseback riding and bicycle accidents. Even though bicycle accidents cause a large number of kidney injuries, these injuries are still very uncommon. Contact sports that are usually considered high-risk, such as football, hockey, and soccer, can cause kidney injuries but it is uncommon.

Most children with kidney disease are not at higher risk for kidney injuries during contact sports. However, injuries can occur so it is important to discuss the risk and your concerns with your child’s healthcare professional before your child participates in any contact sports. Special padding (kidney guards) are available and may offer additional protection. These products are not formally tested like other protective gear such as helmets but may provide some benefit.

Read the full article via the National Kidney Foundation.

Learn more about the Division of Pediatric Nephrology at Children's Mercy.

By Elise Reuter

Although Boston Children's Hospital remains the nation's No. 1 pediatric hospital, Children's Mercy in Kansas City scored higher marks this year, according to the annual ranking of the top pediatric care centers by U.S. News & World Report.

The Kansas City-based children's hospital did not make the honor roll of the top 10 U.S. children's hospitals, but it did rank in the top 50 for all 10 specialties the report measured.

In particular, Children's Mercy advanced in two specialties: cardiology and nephrology.

Read the full article via the Kansas City Business Journal.

See where more Children's Mercy specialties ranked in the annual report.

Kidney disease can be devastating for patients and their families. Often times it means families need to make regular hospital visits for dialysis treatments for years, even a lifetime. But a unique program at Children's Mercy allows for pediatric patients to live a more normal life.

Ayesha Dunlap was born with kidney failure, and although she had a transplant, that kidney failed years ago. So every day the 20-year-old needs dialysis.

"I don't like coming to the hospital a lot," she said. Luckily, she no longer has to.

Dunlap and her family live in Lawrence, so it would typically take them an hour each way to get to and from Children's Mercy for dialysis.

"That'd be a lot, and it's like -- I like to do stuff and call my siblings and go to sports games," she said.

So Dunlap has an at-home peritoneal cycler machine that automatically loads summaries of her nightly dialysis treatments into a "cloud," allowing the staff at Children's Mercy to check her levels and treatment -- without Dunlap ever leaving her home.

"It made a huge difference in their quality of life," pediatric nephrologist Bradley Warady said. "In Ayesha's case, she went to school. Now she's working."

See the full story via Fox 4.

Learn more about the services offered by the Division of Pediatric Nephrology at Children's Mercy.

By Daniel Barnett and Abigail Jaymes

Wetting the bed can be an embarrassing issue for children but medical experts say it’s actually very common.

Children’s Mercy says bedwetting affects five to seven million children in the United States every year. Ten to fifteen percent of children ages five to seven are affected by bedwetting and five percent of children ages eleven to twelve are affected.

There are several factors that go into the problem.

First, constipation can affect a child’s bladder.

Second, family history. Bedwetting runs in the family, so it is typically not an underlying medical problem and the child will usually outgrow it.

Third, an overactive bladder, which occurs when the child cannot store urine in their bladder very well.

According to Pediatric Nurse Practitioner Jamie Neal Lewis, parents can work to prevent their child from wetting the bed by having them practice good daytime habits like making sure they go to the bathroom frequently and encouraging them to relax while doing so.

“Sometimes just cutting back on caffeine, carbonation, other drinks that can irritate your bladder and not let it work as well, such as red dyes or citrusy juices like orange juice or lemonade,” Lewis said. “For some people, cutting back on those types of drinks may make a big difference.”

Read the full article and see the video via KCTV5.

Learn about the The Enuresis (Bedwetting) and Voiding Disorder Clinic at Children's Mercy.

Learn about the other services offered through the Division of Pediatric Nephrology at Children's Mercy.

In what’s considered to be a rare offering among companies across the country, Children's Mercy has enhanced its Extended Illness Time (EIT) benefit to support solid organ and bone marrow donation.

If an employee is eligible and has agreed to serve as a bone marrow or solid organ donor, they may use up to 40 hours of additional EIT (in a rolling 12-month period) when they qualify for a leave of absence due to their inability to work during and immediately following the donation.

This enhanced benefit is known as the “Warady Benefit” in honor of Bradley Warady, MD, Director, Division of Pediatric Nephrology, who has championed organ donation throughout this career and suggested that Children’s Mercy consider such a benefit.

“Employees 20 and 30 years from now will be told about Brad’s advocacy for those who needed gifts of life and hope,” said Human Resources Vice President Robin Faulk, MHR, MA.

"There are very few organizations of any kind across the nation that are offering this benefit," Dr. Warady said of the new enhanced Extended Illness Time benefit that supports employees who are living donors and bears his name. Dr. Warady is a longtime champion of organ donation.

“This is not the norm out there,” Dr. Warady said of the enhanced benefit. “There are very few organizations of any kind across the nation that are offering this benefit. Plain and simple, this benefit has the potential to help save lives. Nothing could be more important. The fact that the benefit has my name attached to it was not only a surprise, but a great honor. The enhancement of the EIT benefit is also evidence of the real impact one can have at Children’s Mercy if you are persistently passionate about something that will help others – in this case, support to make possible the ‘gift of life.’”

In what he described as good timing, Dr. Warady, who serves on the Board of Directors of the National Kidney Foundation (NKF), shared the news of the enhanced benefit with his colleagues at their NKF meeting in New York on Jan. 25.

“Board members applauded the action taken by Children’s Mercy and immediately asked what steps were taken to establish the benefit here so that they, too, could propose the benefit at their institutions.”

Several months ago, Dr. Warady asked that Robin and Carolyn Ehlers, MBA, SPHR, Director of Compensation, Benefits and Wellness, consider a way to support employees who are living donors. The Organ Procurement & Transplantation Network cites these startling statistics:

• More than 114,000 people need a lifesaving organ transplant nationwide, according to Feb. 5 data.
• Every 10 minutes, someone is added to the national transplant waiting list.
• More than 7,000 candidates died in 2016 while on the wait list or within 30 days of leaving the list for personal or medical reasons, without receiving an organ transplant.
• More than 6,000 transplants were made possible in 2017 by living donors. 

“I am extremely proud of Children’s Mercy for taking this unique step because not only does it provide evidence of our hospital’s recognition of the importance of supporting those heroes among us who wish to be kidney and bone marrow donors, but it is also evidence of Children’s Mercy’s desire to lead by example here in Kansas City and throughout the country,” Dr. Warady said.

Dr. Bradley Warady, Director, Division of Pediatric Nephrology

When I started practicing medicine more than three decades ago, it wasn’t uncommon for a doctor to merely tell his patient – this is what you need to do to get better- and assume that the directive would be carried out. There wasn’t a two-way conversation or feedback from the patient and family that was taken into consideration when devising the treatment plan. But times have changed, and for the better. Fast-forward to today and now with an increased emphasis on family engagement and greater acknowledgement of the importance of patient and family input on treatment decisions, improvements in the manner care is being provided as a result of a different and better doctor-patient relationship is beginning to have an impact on outcomes. This isn’t something necessarily taught in medical school or read about in a medical journal; it’s an important development learned firsthand from patients and families over the years.

Practical Management Recommendations

To improve outcomes, health care providers must take the family’s everyday lives into consideration when making management decisions. To help us do that, our team at Children’s Mercy regularly meets with the parents of our dialysis and transplant patients outside of normal business hours. We sit down with the parents (or they may call in on a conference line) and we discuss how we can further improve their child’s care. We ask them to share their thoughts about their children’s school, their children’s relationships with peers and siblings, the difficulty the children have meeting all of the medical demands and the impact that these and other related issues have on their own lives. We solicit their perspective so that we can design a program or treatment plan that is practical for a particular family and, in turn, has a greater chance of being successful.

Of course, they have shared with us that a variety of circumstances need to be considered with devising a plan for an individual patient and family. What are the resources at home? Is it a single-parent household or are both parents living in the house? What is the work schedule of the family? What’s the school schedule of the children? All of these factors and more should come into play when recommending certain therapies. If you ignore these factors, the patient and family may leave the office and say that they will do all of the things asked of them, but in reality they can’t. Not that they won’t, but they can’t. And that’s what we as health care providers have to understand. The medical process, especially as it pertains to complex care, needs to meet the needs of the patient and family, with recognition of the everyday demands that they regularly encounter.

This type of individualized care isn’t easy. It takes work and commitment from both sides. Everyone is busy and it can be difficult for health care providers and families to find the time to sit down and discuss ways to improve the implementation of care. But once we get families to the table and together agree upon treatment plans, which can realistically be implemented, the benefits of the time spent become apparent and families recognize our commitment to work with them as partners and not merely as patients or “customers”.

Surveying Patients: Why Feedback is Important

One of the ways we obtain feedback from our patients and families in the Division of Pediatric Nephrology is by regularly looking at the satisfaction of our patients. We survey our families every time they leave the clinic. We ask them whether the clinic experience met or exceeded their expectations. These brief surveys are extremely valuable as the results help us learn what we’re doing right, in addition to highlighting issues that require attention because they may have a significant impact on the children we’re caring for.

If you don’t collect and use the feedback, I sincerely believe that the likelihood of achieving the goals that you’ve set for yourself and for the families you care for are at risk of not being accomplished. Survey queries addressing a family’s understanding of the treatment recommendations given to them are essential and provides important feedback to the health care team regarding the manner in which medical information is being communicated and the importance of “health literacy” to patient outcomes.

Teen Patients: Make Them Part of the Solution, Not the Problem

The teenage years can be difficult. Teens are already dealing with the normal developmental issues and they are regularly testing boundaries when it comes to independence, responsibility and understanding the consequences of their actions. We all go through this difficult part of life, but throw a complex chronic illness on top of it and the burden can at times be unbearable for these kids.

As health care providers, we need to prioritize their needs as adolescents, while at the same time figure out unique ways to help them understand the importance of their medical care and work with them to design a realistic treatment plan. This has to be an individualized and collaborative process, because every teen is unique, and a thirteen old is different than a sixteen year old or a nineteen year old.

The most important thing we can do is to recognize the variety of complex issues teenagers are facing each and every day and to be sensitive to those issues. By doing that, we can better understand where they’re coming from and they understand where we’re coming from, both of which untimely enhances communication. If we ignore the psychosocial issues that they’re dealing with, we’re going to fail.

Embracing The Patient’s Perspective in Health Care

Improving the provider-patient relationship isn’t exclusive to Nephrology. Appreciation of the everyday challenges that patients and families are confronted with and the need to actively partner to achieve the best possible outcomes should be practiced in all of areas of health care. Providers need to make an effort to actively engage families and children, since they so often can contribute to the solution for problems that exist. As an industry, we need to encourage patient feedback in terms of the approaches that are successful and what’s not successful. Discussing challenges and overcoming obstacles can only improve care.

It takes discipline and the entire multidisciplinary team of doctors, nurses, psychologists, dieticians, pharmacists, Child Life and social workers working together to be successful. Patients aren’t use to being asked by their health care team to help find the strategies that work. Thankfully, that paradigm is changing.

Learn more about the Division of Pediatric Nephrology at Children's Mercy.