In this second episode of our two part series on pediatric hypertension, we talk to Dr. Tammy Brady, a pediatric nephrologist at Johns Hopkins, and Dr. Joshua Samuels, both a pediatric and adult nephrologist at University of Texas Houston. In this episode they review validated blood pressure cuff, home blood pressure monitoring, inpatient blood pressure concerns, end organ cardiac changes, end organ cardiac impacts of hypertension, and choice of antihypertensive.

In this first episode of our two part series on pediatric hypertension, we talk to Dr. Tammy Brady, a pediatric nephrologist at Johns Hopkins, and Dr. Joshua Samuels, both a pediatric and adult nephrologist at University of Texas Houston. In this episode they review ambulatory blood pressure monitors, the basis for our standards for diagnosing pediatric hypertension, the pathophysiology behind obesity increasing the risk of developing hypertension, and ensuring blood pressure is accurately measured.

On this episode, we discuss all things CAKUT-related with the Neonatal Kidney Collaborative. Guests include Dr. Sangeeta Hingorani, a pediatric nephrologist at Seattle Children’s, Dr. Samantha Schwartz, a Six2 crew member and pediatric nephrology fellow at Lurie Children's, Kara Short, a nephrology nurse practitioner at the University of Alabama, Dr. Cara Slagle, a Neonatologist at Indiana University and Lakesha, mother of Landon, a nephrology patient at the University of Alabama. This is a special episode focused on the patient and family perspective of pediatric kidney disease. 

Interested in neonatal nephrology? Check out the NKC website: https://www.babykidney.org/ 

In this episode of the podcast we focus on recurrent urinary tract infections, looking at how we diagnose UTIs, the diagnostic challenges, the causes of recurrent UTIs, and the management. We interview Dr. John David Spencer the division chief of pediatric nephrology at Nationwide Children's Hospital and Dr. David Hains the division chief of pediatric nephrology at Riley Children's Hospital who are both experts on the topic with extensive research into this arena and numerous publications. 

Marsh MC, Junquera GY, Stonebrook E, Spencer JD, Watson JR. Urinary Tract Infections in Children. Pediatr Rev. 2024 May 1;45(5):260-270. doi: 10.1542/pir.2023-006017. PMID: 38689106.

Hains DS, Starr MC, Schwaderer AL. Glomerular Filtration Rate Changes Following UTI in Children With Vesicoureteral Reflux. JAMA Pediatr. 2024 Dec 1;178(12):1366-1368. doi: 10.1001/jamapediatrics.2024.4546. PMID: 39446735; PMCID: PMC11581724.

A NephMadness special episode on minimal change disease in kids, supported by the AJKD and NKF. Guests include Dr. Alvarez Elias, who is an AJKD executive team member, pediatric nephrologist and research scientist at Fresenius, and Dr. Mallory Downie, a pediatric nephrologist at McGill University with her own lab studying genetics behind kidney disease in kids, specifically nephrotic syndrome. We discuss the exciting pathophysiology breakthroughs in MCD and treatment of relapses. Please participate in NephMadness 2025 by following this link: https://www.tourneytopia.com/AJKD/NephMadness/SubmitPicks/Picks.aspx 

For more details on MCD in kids see this commentary: https://ajkdblog.org/2025/03/07/nephmadness-2025-minimal-change-disease-beyond-idiopathic-redefining-nephrotic-syndrome-for-the-modern-era/ 

Dr. Maria Diaz-Gonzalez de Ferris, MD, MPH, PhD, joins us for a conversation about her approach to transitions of care in Nephrology. She is a pediatric nephrologist at UNC Chapel Hill, the Director of the UNC Transition Program otherwise known as STARx. Through her research work focusing on healthcare transitions for children with medical complexity, she has developed a system of healthcare checkpoints and resources that assess autonomy and self-management. In this episode, we briefly discuss the importance of transitions of care, general guidelines and resources, approaches in specialized populations such as transplant/CKD/ESRD, and resources that are available to those interested in optimizing their local transitions of care infrastructure.

Resources:

National and International Guidelines

STARx Program Description: https://www.med.unc.edu/transition/about-us-1/

STARx Transition Tools (Healthcare passport, All you need is love transition syllabus, Transition Index readiness assessment, STARx questionnaire): https://www.med.unc.edu/transition/transition-tools/

Drs. Stu Goldstein, Professor & Director of the Center of Acute Care Nephrology at Cincinnati Children's, and Jordan Symons, Professor, Fellowship Program Director and Apheresis Director at Seattle Children's Hospital provide their expertise regarding pediatric acute kidney injury. We discuss the emergence of the sub-specialty of critical care nephrology, harms of fluid overload, utility of biomarkers, benefits of early AKI awareness and CRRT therapy and an individualized approach to the pediatric patient with an AKI.

References

AWARE Study NEJM 2016- https://pubmed.ncbi.nlm.nih.gov/27959707/

Renal Angina Index (RAI) validation 2014 Kidney Int  -https://pubmed.ncbi.nlm.nih.gov/24048379/

Renal Angina Index & Fluid Overload Prediction BMC Neph 2021- https://pubmed.ncbi.nlm.nih.gov/34635072/

TAKING FOCUS-2 RAI + uNGAL improves outcomes Kidney Int. 2023- https://pubmed.ncbi.nlm.nih.gov/38106571/

Fluid Overload Review Ped Neph 2024- https://pubmed.ncbi.nlm.nih.gov/37861865/

Urinary NGAL Validation Kidney Int. 2024-https://pubmed.ncbi.nlm.nih.gov/39156146/ 

Urinary NGAL is FDA cleared in children! https://bioporto.us/pronephro-aki/ 

For this episode on ARPKD interviewed Dr. Lisa Guay-Woodford a clinician scientist at Children’s Hospital of Philadelphia who is a world-renowned expert on cystic kidney diseases. She was part of one of the teams that discovered the ARPKD gene and provides fascinating insight into the history and management of the condition.

References

ARPKD genetic variations: https://www.sciencedirect.com/science/article/abs/pii/S1096719209002947

Bilateral nephrectomy outcomes: https://www.nature.com/articles/s41598-020-71956-1 

We talk to the experts in the Neonatal Kidney Collaborative (NKC) about the recently published guidelines regarding kidney follow-up for NICU graduates, a product of the NIH-supported workshop in 2024 spearheaded by Dr. Michelle Starr of Indiana University/Riley Children's Hospital. Guests include Dr. Marissa DeFreitas, pediatric nephrologist at the University of Miami, Dr. Matt Harer, neonatologist at the University of Wisconsin, Dr. Kat Gist, pediatric cardiac intensivist at Cincinnati Children's, Dr. Heidi Steflik, neonatologist at the Medical University of South Carolina, and Dr. Tom Forbes, pediatric nephrologist at Royal Children's Hospital in Melbourne, Australia. 

Links

Kidney Monitoring for NICU Grads Follow-Up Guidelines: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2823652

AWAKEN study: https://pmc.ncbi.nlm.nih.gov/articles/PMC5933049/ 

Join the NKC! https://www.babykidney.org/ 

Dr. Matthew Sampson, a pediatric nephrologist and associate professor of pediatrics at Harvard Medical School, walks us through genetic testing for pediatric patients with kidney disease. He discusses indications for genetic testing and how to interpret results. He also talks about his lab and work as a genomics researcher. 

Episode References