The Culture of Different MKTG_150064494_2018 Service Line Big Book Full_FIN

KIDNEY CENTER NEPHROLOGY A Collaboration to Curb Acute Kidney Injury in the ICU LEADERSHIP: Jens Goebel, MD, Chief, Pediatric Nephrology READ MORE ABOUT NEPHROLOGY: Nephrology helps save baby with CDH, p. 44 “For Adrian to Live, His Immune System Had to Die,” p. 68 “A Three-Pronged Focus for a Three- Pronged Problem,” p. 80 Nearly one in four kids will sustain acute kidney injury during a stay in intensive care. Bringing together nephrology, neonatology, and pediatric and cardiac intensive care, the Pediatric Kidney Injury and Disease Stewardship program works to study and prevent kidney injury across several pediatric care units at Children’s Hospital Colorado: • NICU: Ischemic kidney injury often results from hypoxia at birth. Using urine biomarkers like NGAL, the team is working to identify and stop the progression of kidney injury sooner. • PICU: Correlating continuous renal replacement therapy (CRRT) machine data with electronic medical record data, the team seeks to predict and avert problems with CRRT circuit life. • CICU: The drug milrinone — standard after heart surgery — can injure some patients’ kidneys. The team has identified two biomarkers that may predict impaired clearance of the drug, which could help guide care and avert injury. • Hospital-wide: The team recently rolled out an automatic electronic health record surveillance program that flags patients exposed to nephrotoxic medications in an effort to reduce kidney injury across the board. Our program leadership includes faculty from four key areas: D E PA RT M E N T O F N E P H R O L O G Y 36 Specialists including nephrologists, pharmacists, nurse practitioners, nurse- coordinators, psychologists, renal dietitians, social workers 4 Kidney transplant surgeons 100% Survival three years out from pediatric kidney transplants performed 2011-2013 100% Graft survival one year out from pediatric kidney transplants performed 2014-2016 Pediatric nephrologist Danielle Soranno, MD Neonatologist Jason Gein, MD Pediatric intensivist Timothy Stidham, MD Pediatric cardiac intensivist Katja Gist, DO OVER 50% Of transplants from living donors in 2017 The Culture of Different 73

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