“Many people think of kidney disease as being a concern only for older people, however, both children and adults can suffer kidney failure, with dialysis becoming a necessary part of life for those families,” says paediatric nephrologist Errol Gottlich, who oversees the NRC KidneyKidz unit at Rochester Place, Sandton.
“Paediatric dialysis is a rare medical requirement, with an incidence of five to 10 new cases per million children, yet it is nothing less than life saving for the children who need it. The kidneys are vital in purifying the blood and maintaining the necessary balance in our body. When the kidneys cannot fulfil this function, the person requires regular dialysis to artificially remove toxins from their body.
“Some reasons why children may require dialysis include congenital abnormalities of the kidneys and bladder, after an infection, complications of HIV, auto-immune diseases, or when acute kidney failure, irrespective of the cause, becomes a chronic condition,” Gottlich says.
Together with National Renal Care, which has a network of 71 dedicated dialysis units around South Africa, Gottlich has established NRC KidneyKidz to serve the needs of paediatric renal patients in a family-centred, caring environment. The unit offers chronic haemodialysis, peritoneal dialysis, and a mobile acute care team on call for in-hospital acute therapies.
“Children can sometimes find clinical settings rather intimidating, and so we have created a unit especially around how paediatric renal patients will use the space, and we have tried to make it as welcoming as possible for children and their families, with friendly, paediatric-trained staff,” says Chevon Clark, chief executive officer of NRC.
The new unit uses the advanced digital healthcare technology of National Renal Care’s NephrOn system, which enhances patient safety and multidisciplinary collaboration through electronic medical records.
“The children usually need two or three dialysis sessions per week, for three to four hours at a time. This is a considerable amount of time in a family’s busy schedule, so we try to make this unit a home away from home,” Gottlich says.
“Many children sleep during dialysis sessions but we have fun activities, games, and TV programmes to help them pass the time. We also have refreshments and workstations for parents or family members to carry on with their work commitments during their child’s dialysis sessions.”
A multidisciplinary team looks after patients’ medical and surgical needs, including access to a dietician where needed. This is in addition to NRC’s value-added services, including nutritional guidelines, patient education and support groups for patients and their families.
“Through the secure NephrOn platform, the treating specialists, NRC nurses and other healthcare practitioners involved in a patient’s care can access and check on each of their patients, as the system automatically records clinically relevant data, as well as medical notes and additional context, which are accessible to the treating medical team remotely by means of a mobile device,” Clark says.
“Having access always to the most comprehensive and up to date information at their fingertips has the important benefit of informing clinical decision making in real time. Nurses no longer have to capture all information manually on a patient’s file and can focus on the clinical and nursing aspects of their duties, spending more time providing personalised care to each patient. This is especially important when it comes to children.
“Data collected on treatment, process and outcome measures are submitted to NRC’s database, called NephrOn, and the Discovery kidney care programme is an extra measure to ensure the quality and consistency of care delivered to our patients. This ensures that the care provided is aligned to best practice and guided to provide the best possible outcomes for all our patients,” Gottlich adds.
The invaluable support of Gottlich and Liz Trollope for families regarding the kidney transplant process recently culminated in four of NRC KidneyKidz’ patients receiving transplants within a single month – with all indications so far that the operations were successful. The children will no longer be dependent on dialysis.
“On behalf of NRC, we thank Gottlich and everyone involved in bringing this specialised children’s dialysis unit to fruition. We wish the NRC KidneyKidz unit and its extended family of patients, their parents, health practitioners and staff everything of the best for the future.
"We trust it will make a significant contribution to paediatric renal care,” Clark concluded.