Le Bonheur's Pediatric Dialysis Unit is tailored to the needs of children.
The first patient Dr. Robert Wyatt attended on his very first surgery regimen as a third-year student in medical school was a veteran dying of renal failure. In 1971, there was no thought of offering this man dialysis. The medical subspecialty of nephrology only dates back to the 1960s, when committees were appointed to decide which patients would get the benefits of the newly developed, life-saving treatment that could filter toxins out of the blood to help support failing kidneys.
Now the director of Le Bonheur’s Pediatric Nephrology Division, in conjunction with the University of Tennessee Health Science Center, Wyatt can appreciate the quality of services his staff is capable of offering their young patients. Recognized as the first pediatric dialysis unit in the region, Le Bonheur’s new unit is located in the Children’s Foundation Research Center, in what used to be the old hospital’s cafeteria before the new 12-story patient-care tower opened last year.
“One of the major reasons I came to Memphis had to do with the facilities here, and the fact that this would be a place where we would train the nephrologists of the future,” Wyatt says.
“With adults, you see dialysis units on many street corners in all parts of Memphis, whereas we are the dialysis unit for a majority of the children in a total population of 2 million.”
The setup utilizes the space for maximum efficiency in administering dialytic treatments to children suffering from various diseases or afflictions resulting in kidney failure. While renal failure in adults is largely attributed to diabetes and high blood pressure, children suffer vastly different circumstances such as kidney malformations, diseases of kidney filters, or inborn errors of metabolism.
Hemodialysis occurs three days a week within the unit, wherein the patient is hooked up to a dialyzer for an average of three to four hours, while peritoneal dialysis is a home therapy which occurs inside the body’s abdominal cavity. An additional chair brings the unit’s capacity to seven for hemodialysis treatment, while private rooms serve as training areas for kids and their families on the alternative peritoneal dialysis route. Le Bonheur’s program also handles dialysis for St. Jude Children’s Research Hospital, with its thoroughly knowledgeable staff administering treatment on-site.
“Chronic kidney disease never goes away,” says Dr. Colleen Hastings, medical director of the Le Bonheur dialysis program. “Whether the patient is on dialysis or they’ve got a kidney transplant, they’re always going to need medical care. That’s the most difficult thing for these kids. They’re going to be dealing with medicine and doctors for their entire lives.”
Hastings brings some unique insight to her position. She is one of a handful of doctors in the country board-certified in both pediatric nephrology and internal medicine nephrology. Her other two appointments cover patient care at Le Bonheur as a pediatric specialist and adult medicine in her outpatient clinic for UT Medical Group. Hastings sought the duality, with the help of Wyatt and others, in the interest of easing her patients’ transition from pediatric to adult care.
“I felt like it would be great for continuity of care to be able to follow these patients as they aged out of Le Bonheur,” Hastings says.
“I can take the kids that graduate from here and still see them in the adult unit. It makes it a little bit easier for them, because there’s somebody there that knows them and knows their history.”
The ultimate goal for all the children the unit treats is to get them a kidney transplant as soon as possible. Le Bonheur performs about six pediatric kidney transplants a year. But many of the patients face obstacles that prolong the process, making the unit all the more necessary in providing specialized treatment tailored to the needs of children.
Le Bonheur’s dialysis unit employs two teachers who work with school schedules and tutor the kids going through hemodialysis, stuck for hours at a time on a machine. A renal dietitian keeps the patients on a restricted diet and helps prepare special meals, particularly low in phosphorous, for them to take to school. They also maintain one nurse to every two kids, ensuring the best care possible for those in greatest need.