Pascale H. Lane, MD
Pediatric Nephrology - Faculty Development - Biomedical Research Issues
What is Nephrology?
Nephrology literally means the study of the kidneys. As a Pediatric Nephrologist, I am trained to diagnose and treat kidney problems in children.
Becoming a Pediatric Nephrologist requires 3 years of fellowship after 3 years of residency training in General Pediatrics. The American Board of Pediatrics includes a Sub-Board in Pediatric Nephrology for certification of its practitioners. I am currently enrolled in the Maintenance of Certification Program for this subspecialty which means I am committed to ongoing education and testing of my skills.
The kidneys usually sit in the upper back, just sticking out from beneath the ribs. Kidneys filter the blood; ~20% of each heart beat goes directly to these organs for cleansing. In addition to clearing wastes, the kidneys must keep good things in the body after they are filtered. The kidneys also make hormones that control blood pressure, manufacture of red blood cells by the bone marrow, and balance of chemicals that make up our bones.
Pediatric Nephrologists treat a whole range of problems which include:
- Congenital malformations of the urinary tract
- Inherited diseases of the kidneys
- Urinary tract infections
- Various forms of nephritis (inflammation of the kidneys)
- Hypertension
- Acute kidney injury
- Chronic kidney disease
- End-stage renal failure requiring dialysis and/or transplantation
Many kidney problems can be diagnosed with blood and urine tests. Frequently the kidneys must be imaged to look at their size, position, and other structural issues.
- Ultrasound is the most common test ordered. It can demonstrate kidney size, position, dilatation, echotexture, and other abnormalities. With Doppler flow studies, the size and flow through the kidney vessels can also be assessed.
- Voiding cystourethrogram (VCUG) involves placing a catheter in the bladder, filling the bladder with a dye, and taking pictures as the child voids. This study can diagnose vesicoureteral reflux, abnormalities of the bladder, and blockage in the urethra such as posterior urethral valves.
- Nuclear scans use a small amount of a radioactive tracer to demonstrate blood flow and function of the kidneys. Some can demonstrate small scars; others provide the best indication of obstruction in the rest of the urinary tract.
- CT scanning provides the most sensitive study for the detection of kidney stones.
The ultimate test we perform is a kidney biopsy. For this study, a special needle is placed in one kidney and pieces are removed for laboratory evaluation. Information for patients and their parents can be downloaded and printed here.
