Drs. Donna Claes, Vivian Shih and Annie Kouri (our co-host) discuss their roles as pediatric dialysis directors at their institutions. Donna Claes is an associate professor of pediatric nephrology and chronic dialysis director at Cincinnati Children's and Vivian Shih is an assistant professor of pediatric nephrology and acute dialysis director at Children's Hospital Colorado. We talk about the road to becoming a dialysis director, what the job entails, the challenges, the rewarding aspects of the job and tips for those who are considering stepping into this position at their institution.