Arkansas Children’s pediatric nephrologists created multidisciplinary clinics to provide care at every stage of complex kidney disease.
Launched in 2018, the urology nephrology clinic (UroNeph) at Arkansas Children’s Hospital provides a convenient, single location for patients to receive kidney and urology care.
Arkansas Children’s Hospital physicians created the UroNeph Clinic when they saw families struggling to attend multiple urology and nephrology appointments in separate locations.
“Families were frustrated by multiple visits and repetition of information at each appointment,” said Rachel Millner, M.D., pediatric nephrologist at Arkansas Children’s Hospital and assistant professor of Pediatrics in the Division of Nephrology at the University of Arkansas for Medical Sciences (UAMS). “The UroNeph Clinic meets a patient’s care needs while addressing the strain on families.”
The team conducts initial consultations at the UroNeph Clinic tracks patient progress through monthly follow-up appointments and addresses ongoing questions. The clinic has also allowed physicians to diagnose chronic bladder conditions that could result in kidney dysfunction.
"Open lines of communication between urology and nephrology allow us to do what's best for our patients," said Rachel Millner, M.D., pediatric nephrologist at Arkansas Children's Hospital. "I'm most proud of how well our team collaborates to provide this complex care."
Data from the Scientific Registry of Transplant Recipients (SRTR) indicates that 89% of Arkansas Children's patients in need of a transplant have received one within a year. The national average is only 17%.
Angela D. Rowe, Perioperative Services Director, accreditation and transplant director at Arkansas Children’s Hospital, attributes much of this level of success to the collaborative team of transplant coordinators and the transplant evaluation process.
As the only pediatric kidney transplant center in the state, Arkansas Children's Hospital sets its evaluation apart by integrating a hands-on approach. An interdisciplinary team of nephrologists, pharmacists, dietitians, social workers and financial advisors support patients and families during their entire transplant journey.
"This team differentiates our transplant evaluation clinic," Rowe said. "Needs and challenges pre-transplant will likely be present post-transplant, so this collaborative team identifies and addresses these challenges as a patient continues to grow and develop."
Parents of children with advanced kidney disease often feel overwhelmed with the information provided by various specialists. The advanced chronic kidney disease (CKD) clinic at Arkansas Children's Hospital was created to ease communications between specialists and families, while allowing for more comprehensive, patient-centered care.
“We felt families weren’t receiving enough time at each visit to make informed decisions,” said Saritha Ranabothu, M.D., pediatric nephrologist and transplant director at Arkansas Children’s Hospital and associate professor of Pediatrics in the Division of Nephrology at UAMS. “The advanced CKD clinic enables us to discuss treatment options, as well as identify barriers to kidney transplant before dialysis, which allows for better outcomes.”
The advanced CKD clinic at Arkansas Children's Hospital was specifically designed to introduce kidney replacement therapies. Available treatments, such as peritoneal dialysis, hemodialysis and preemptive transplant, are now thoroughly explained to patients and families previously unaware of these options.
"This clinic shifts the focus from disease complications to what the patient's future could be using these treatment methods," Dr. Ranabothu said. "We're able to help a patient understand what kidney replacement therapy entails."
The advanced CKD clinic currently follows 30 patients, with more expected in the coming year.
"Inspiration for the CKD clinic arose from the desire to improve preemptive transplant rates to increase patient survival," Dr. Ranabothu said. "By identifying and preparing for barriers early on, we've ultimately improved patients' overall outcomes, as well as our transplantation rate."
The Arkansas Children's nephrology team is nationally known for treating a wide range of kidney diseases and hypertension.
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