Improving pediatric kidney care in India

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ISN Fellowship makes for better pediatric kidney care in India.

Pediatric nephrology is an emerging specialty in India. Children with kidney problems often don’t get timely treatment. Their parents are either unaware of their condition or cannot afford the cost of treatment. ISN is trying to respond to these issues by offering its members the chance to carry out their fellowship in a developed country. By sharing what they know doctors can strike the balance in kidney care worldwide.

Susan Uthup from the SAT Hospital Government Medical College in Thiruvananthapuram took part in the Fellowship Program, spending six months in the pediatric nephrology unit at the Cincinnati Children’s Hospital Medical Center (CCHMC). She shares how she hopes to improve clinical nephrology services for children locally especially by offering Continuous Renal Replacement Therapy (CRRT) for younger patients.

She explains: “Pediatric Nephrology is an evolving specialty in my state. Pediatric dialysis, CRRT and transplantation are still in the primitive phase. These modalities are possible only in bigger children. Smaller children especially those weighing less than 15 kg are given only conservative management in End Stage Renal Disease.”

The fetal End Stage Renal Disease (ESRD) program at CCHMC was an eye-opener. She adds: “I will try to coordinate and develop a pediatric nephro-urology team to provide more advanced care including transplantation in small children. Developing a pediatric nephrology center of excellence in my institution is a mission to be accomplished. The fellowship program has not only helped improve the quality of work in my unit but has also helped to offer training for postgraduate clinical hands-on training.”

The pediatric nephrology unit at SAT Hospital Government Medical College is the first and only one of its kind caring for young kidney patients throughout Kerala state, India. Susan is the only qualified nephrologist in the unit, giving comprehensive care for young patients suffering from acute and chronic kidney disease including peritoneal and hemodialysis. The center has no expertise in Continuous Renal Replacement Therapy, hemodialysis and transplantation for patients below 5 years old.

“I am really thankful to ISN for giving me this wonderful opportunity to broaden my perspective in pediatric nephrology. Cincinnati Children’s Hospital Medical Center being the 3rd best pediatric nephrology center in US, I learned the latest developments in clinical pediatric nephrology, transplantation and dialysis in children,” she adds.

Being an ISN Fellow helps build ties for the future in the hope of advancing care in the long term. Susan hopes to work with Prasad Devarajan, Professor of Pediatrics and Developmental Biology at Cincinnati Children’s Research Foundation, a pioneer in Biomarker development in acute kidney failure. “The pediatric urology division at CCHMC carries out pioneer work on children with CAKUT. I want to familiarize myself with Renoprotection and optimum bladder management given to children with spinal dysraphism.”