End-Stage Renal Disease Program

Our Innovative Approach 

The End-Stage Renal Disease Program at Boston Children’s Hospital is dedicated to providing expert diagnosis and treatment of every condition that results in chronic kidney (renal) failure in children. Our team works closely with specialists in other departments in the hospital to develop individualized care plans that meet each child’s medical needs.

The two most important parts of our treatment approach are dialysis and kidney transplantation.
 

Dialysis 

What is dialysis?

When a child’s kidneys don’t function properly, dialysis is used to filter a child’s blood and maintain the right balance of water and minerals. We may recommend a course of dialysis when a child is waiting for a kidney transplant, when a transplant is not yet the right option or when a child has just had an unsuccessful kidney transplant. 

There are two types of dialysis, both of which are used to filter toxins from the blood: 

• Peritoneal dialysis can be performed at home and is gentle and untaxing on the body. In peritoneal dialysis, a thin plastic tube (catheter) fills the child’s abdomen with a special solution called dialysate. Dialysate removes waste products from the blood before being drained back out of the body, either at night or at regular intervals. This process is known as an “exchange”.
   
• Hemodialysis is performed at the hospital or at a dialysis center. In hemodialysis, a child is connected to a large machine called a dialyzer that takes blood out of the body, cleans and filters it and returns it to the body in a continuous process. Only a very small amount of blood is filtered at a time. 

Our Dialysis Unit

Children who require dialysis are treated in our seven-bed Dialysis Unit, located on Farley 4 on the main campus in Boston.

Our dialysis unit is home to an experienced and caring staff of doctors, nurses, a dietitian, social worker and a Child Life specialist. Each member of our staff has specialized training in the care of children and young adults with kidney disease. 

• We offer hemodialysis Monday through Saturday from 7 a.m. to 7 p.m.
• Our multidisciplinary team also oversees the training and supervises the provision of home-based peritoneal dialysis for families and patients choosing that that treatment option.

 Learn more

• What to do in case of an emergency
• About kidney dialysis
• Information from the National Kidney Foundation
   

Kidney Transplantation

Kidney transplants are performed when a child with severe end-stage kidney disease (ESRD) no longer responds to treatment. In a kidney transplant operation, a diseased kidney is replaced with a healthy one from another person. 

Members of the Kidney Transplant Program at Boston Children’s provide comprehensive care to infants and children undergoing kidney transplantation. Ours is the only program in New England that is entirely focused on the care of children. Since the program’s inception in 1971, the team has performed more than 630 transplants.