The Department of Nephrology provides inpatient, day care and outpatient services for children and young adults with kidney disease. The services provided include medical treatment, dialysis, and follow-up of kidney transplant patients.
Given that most kidney conditions are chronic, children will be known to the service for a long time. This important issue influences the way services are delivered. The department works closely with other hospital departments to provide care to children with complex multisystem conditions.
Referrals are accepted from General Practitioners and Pediatricians throughout the region and North Wales. Patients are referred for various different reasons such as:
- Acute kidney injury; a sudden loss, usually temporary, of kidney function
- Chronic kidney disease; long term reduced kidney function, often a high blood creatinine level
- Haematuria (blood loss in the urine)
- Kidney stones
- Chronic or recurrent urinary tract infections
- Proteinuria and nephrotic syndrome (protein loss in urine)
- High blood pressure
- Glomerulonephritis (kidney inflammation)
- Cystic kidney disease and other kidney malformation
- Abnormalities of body fluids, electrolytes and acid levels
The Alder Hey Department of Nephrology was among the first in the UK to offer dialysis to children with kidney failure (haemodialysis from 1968 and peritoneal dialysis from 1973/74). The kidney transplant service commenced in 1977/78. Since the early 1990’s, Alder Hey has collaborated with Royal Manchester Children’s Hospital and Manchester Royal Infirmary in a supra-regional paediatric kidney transplant programme.
Acute and chronic renal replacement therapy is provided. For long term patients both in-center haemodialysis and home peritoneal dialysis are fully supported. Preparation for, and follow up of kidney transplant recipients is undertaken. The department also provides plasma exchange therapy and support for premature infants with kidney problems at Liverpool Women’s Hospital.
Future anticipated developments
A New Dialysis unit within the Children’s Health Park. This will provide greater space and privacy for patients.
Increased involvement of other specialties the care pathway i.e. Professions Allied to Medicine in an extended role.
Managing increasingly complex patients with End Stage Kidney Failure for transplantation and chronic dialysis.
Increasing near patient testing – biochemistry.
Increasing technology of dialysis modalities – haemodialfiltration, daily & nocturnal haemodialysis.
Patients with long-term kidney problems generally transfer to adult services at 16 – 18 years of age, depending upon individual needs. Young people are identified as early as 14 years to begin adjusting the way their care is delivered to prepare them for adult services. The department has links with several adult nephrology units to facilitate transfer for continuing care.