Hackensack University Medical Center - Where medicine meets innovation

Kidney Diseases and Hypertension (Nephrology)

The Division of Kidney Diseases and Hypertension (Nephrology) has 2 board-certified pediatric nephrologists. These physicians are specialty trained in the diagnosis and treatment of the full scope of kidney diseases and hypertension in children of all ages. Our pediatric nephrology team also includes a certified nephrology nurse, pediatric social workers, a registered dietitian, child-life specialists, and a medical secretary. You may meet members of the team in the Pediatric Emergency Room, in the Neonatal Intensive Care Unit, in the Pediatric Intensive Care Unit, on the General Pediatric Wards, or in their outpatient offices.

Whether your child is suffering from bed-wetting or end-stage kidney failure, or in need of a kidney transplant or other surgical procedure, our Center for Pediatric Kidney Diseases (Nephrology) offers a comprehensive array of diagnostic and treatment services.

Nephrotic Syndrome and Glomerulonephritis: There should be no blood and no protein in the urine. If your pediatrician has detected blood or protein in the urine then your child may have a kidney disease. Our doctors offer the time-tested standards of care but also are exploring new, innovative, and experimental treatments, which are showing the promises of increased cure rates with fewer side effects.

Lupus and other auto-immune diseases: When the immune system attacks the ‘self’ the kidneys may become damaged. The pediatric nephrology team works closely with the pediatric rheumatology team in the care of children with autoimmune diseases. There is frequent collaboration and coordination of care between the rheumatologic and nephrologic teams in the treatment of patients with these complex diseases to ensure the best outcomes.

Hypertension: A helpful test to evaluate high blood pressure in children is the 24-hour ambulatory blood pressure monitor. Because children can be nervous at the doctor’s office their blood pressure may rise temporarily, a condition called ‘White Coat Hypertension.’ In order to figure out if the high blood pressure is just temporary or is persistent and due to a medical condition 24-hour ambulatory blood pressure monitoring is often recommended. Then the child’s blood pressure is monitored at home while playing, sleeping, eating, and doing their usual activities. Approximately half of the children referred for evaluation of their high office blood pressures are found to have entirely normal readings at home and require no further testing.

If the child’s blood pressure remains high on the 24 hour test then he/she will undergo additional testing. Unlike high blood pressure in adults, approximately 90 percent of the cases of hypertension in children are caused by a kidney problem. Our American Society of Hypertension certified Specialist in Clinical Hypertension, Leigh Ettinger, M.D., and his team carefully evaluate each patient through a series of tests to determine if the hypertension is due to any anatomic, renal, hormonal, or cardiac cause. Then an individualized treatment program will be discussed with the family.

Day Accommodations Suite
Patients with kidney disease may undergo testing or procedures at our child-friendly outpatient Day Accommodation Suite.

Dialysis
The pediatric dialysis unit at the Joseph M. Sanzari Children’s Hospital is unique to New Jersey and is rare among hospitals in the nation. Our Pediatric Dialysis Unit --which provides this life-saving treatment solely to children with acute and chronic kidney failure – has been designed to be child-friendly and offers internet access, individual televisions, and other amenities at each station. Our unit uses the most advanced hemodialysis modalities available today to remove waste from the body and to restore the body’s metabolism. For those families that wish to perform dialysis at home peritoneal dialysis services are offered from infancy upwards.

Kidney Transplantation
As one of New Jersey’s few hospitals that provide kidney transplantation, Hackensack University Medical Center offers this life-sustaining treatment to children of all ages, even infants. Our nationally known transplant surgeon, Michael Shapiro, M.D., is skilled in the special techniques necessary for pediatric kidney transplantation using both live donor kidneys and kidneys from deceased donors.

Kidney Biopsies
When a kidney biopsy is needed to make a diagnosis the expert Interventional Radiologists at the Hackensack University Medical Center perform the procedure under ultrasound guidance with the assistance of an Anesthesiologist. Biopsies are performed in the morning. The patients are usually discharged by the end of the day.

Urology
Nephrologists at the Center for Pediatric Kidney Diseases (Nephrology) work closely with pediatric urologists at the Joseph M. Sanzari Children’s Hospital to diagnose and treat urologic diseases associated with the kidneys and other organs of the urinary system.