Pediatric Nephrology Clinical Affairs

The Division of Pediatric Nephrology’s expertise encompasses all aspects of renal disease and fluid and electrolyte abnormalities. Patients with renal disorders are referred to us from all over North Texas, as well as parts of Louisiana and Oklahoma.

We provide outpatient and inpatient consultation for Children's Medical Center Dallas, with pediatric nephrologists available 24 hours a day, seven days a week, to evaluate and treat children with renal abnormalities. We also provide outpatient care at Children’s Medical Center Plano through the UT Southwestern Pediatric Group.

Featured Programs

Acute Care Nephrology

Advances in pediatric renal replacement therapies (RRT), along with the challenges of providing multidisciplinary care for medically complex patients, have led to an increased need for critical care nephrology expertise and support across all pediatric, neonatal, and cardiac intensive care units (ICUs).

Under the leadership of Keri Drake, M.D., Medical Director of the Acute Care Nephrology Program, and a highly collaborative multidisciplinary team, our program has become a national leader in advancing pediatric extracorporeal therapies.

We provide comprehensive renal and liver support services across all ICUs – pediatric, trauma, cardiac, and neonatal – ensuring that every critically ill child has access to timely expert care.

• We offer three advanced dialysis modalities tailored to patient size and clinical need – PrisMax, Carpediem, and Aquadex – enabling precision kidney support from neonates to adolescents.
• We are also among the few pediatric centers in the country offering Molecular Adsorbent Recirculating System (MARS) therapy for liver support, providing lifesaving dialysis for children with acute liver failure.
• Our team is proud to be the ninth center in the nation to introduce Quelimmune, an innovative extracorporeal selective cytopheretic device designed to help modulate inflammation in critically ill patients with acute kidney injury.

Our program’s impact extends beyond the bedside through participation in major multicenter research collaboratives, including WE-ROCK, AWAKEN, and ICONIC, which aim to improve kidney outcomes and shape best practices for critically ill children worldwide.

Our Acute Care Nephrology Program offers opportunities to work with leading-edge extracorporeal technologies, participate in national research initiatives, and help shape institutional changes that influence critical care nephrology on a larger scale.

Chronic Dialysis Program Patient Care

The Chronic Dialysis Program at Children’s Medical Center Dallas is recognized as the largest and most comprehensive pediatric end-stage renal disease (ESRD) programs in North Texas. Our mission is to provide exceptional, compassionate, and family-centered care to children living with chronic kidney failure.

We offer both in-center hemodialysis and home-based peritoneal dialysis services, allowing each patient's treatment plan to be tailored to their medical needs, family circumstances, and lifestyle. The program was thoughtfully designed with children and their families in mind, ensuring that every aspect of care – from medical management to emotional support – takes place in a safe, comfortable, and child-friendly environment.

Our highly skilled interdisciplinary team includes:

• Pediatric nephrologists
• Advanced practice providers
• Dialysis nurses
• Dietitians
• Social workers
• Child life specialists
• Dialysis technicians
• A psychologist
• A patient educator

Working collaboratively, this team provides comprehensive, holistic care that supports not only the child’s physical health but also their emotional well-being, nutrition, education, and family adjustment.

Each year, we care for a large number of children with complex renal conditions. This breadth of experience has made our team experts in managing the unique medical and developmental needs of pediatric dialysis patients. Through evidence-based practice, family engagement, and continuous innovation, we strive to improve the quality of life and long-term outcomes for every child we serve.

We are also proud participants in the Standardizing Care to Improve Outcomes in Pediatric End-Stage Kidney Disease (SCOPE) Collaborative, a national quality improvement network that brings together pediatric dialysis centers across the country. The SCOPE Collaborative focuses on enhancing the safety, quality, and outcomes of dialysis care by reducing complications such as bloodstream infections and improving adherence to best practices.

Participation in SCOPE allows our team to benchmark performance, share data-driven strategies, and adopt the latest innovations in pediatric renal care. Through this collaboration, we continuously refine our protocols and maintain the highest standards of excellence in dialysis care for children.

Pediatric Kidney Transplant Program

The Pediatric Kidney Transplant Program at Children’s Health has a long history of excellence. Our faculty collaborate closely with UT Southwestern Medical Center. Our multidisciplinary team includes nephrologists, transplant surgeons, psychosocial and allied health support staff, and more. We have performed more than 500 kidney transplants since the program was created in 1964. In 2024, we achieved the second-highest annual kidney transplant volume in Children’s Health history – ranking us first in North Texas.

We have notched a number of firsts since UTSW surgeons performed the first renal transplant in Texas in 1964. Other milestones include performing the first combined kidney/liver transplant at Children’s Medical Center (1991) and the first pediatric kidney/heart transplant in Texas (2005). More recently, our program was one of the first to use Oxlumo® (lumasiran) in a pediatric kidney transplant at Children’s Health – for a 3-year-old child with primary hyperoxaluria Type 1, one of the youngest patients globally – avoiding the need for liver transplant.

Measurement of Bone Mineral Density

The Division provides a specialized service dedicated to the accurate quantification of bone mineral density (BMD). Assessment of BMD is essential for the diagnosis, monitoring, and management of metabolic bone disorders.

Many patients with endocrine, rheumatologic, orthopedic, inflammatory bowel disease, cystic fibrosis, and renal diseases are at increased risk of reduced bone mineral density. Accurate measurement of BMD allows for the early detection of osteopenia and/or osteoporosis, enabling timely initiation of targeted therapies such as:

• Calcium and vitamin D supplementation
• Antiresorptive or anabolic agents
• Lifestyle interventions

Early intervention not only helps improve overall bone health but also significantly reduces the risk of fractures, skeletal deformities, nephrocalcinosis, and hypercalcemia, thereby decreasing morbidity and improving quality of life.

By offering this service, the Division demonstrates its commitment to comprehensive patient care and multidisciplinary collaboration, ensuring that patients within the hospital have access to state-of-the-art diagnostic tools that guide evidence-based management of bone health.

Measurement of Renal Function

Assessment of renal function is a cornerstone of managing patients with kidney disease and systemic disorders that affect kidney function. Traditionally, serum creatinine is used to evaluate kidney function; however, this parameter is an indirect and often unreliable marker of glomerular filtration rate (GFR).

Serum creatinine levels are influenced not only by renal clearance but also by muscle mass and dietary intake, particularly in those with chronic illnesses, malnutrition, or reduced physical activity. As a result, serum creatinine often underestimates the degree of renal impairment in these patients.

To overcome these limitations, the Division provides direct measurement of glomerular filtration rate using the Glofil® technique, a well-established way of assessing true renal function. The Glofil method involves the use of radiolabeled iothalamate, which is freely filtered by the glomeruli and neither secreted nor reabsorbed by the renal tubules. This allows for an accurate and quantitative determination of GFR, independent of muscle mass or other confounding factors.

This advanced testing capability enables precise evaluation of kidney function in children with a wide range of conditions, including:

• Congenital or acquired renal disease
• Chronic systemic illnesses
• Patients undergoing chemotherapy
• Pre-transplant evaluation
• Post-transplant monitoring

By offering this specialized service, the Division enhances diagnostic accuracy, optimizes treatment planning, and contributes to improved long-term renal outcomes for pediatric patients within the hospital.