Children's Hospital Colorado

Pediatric Nephrology Research

In the Department of Nephrology at Children's Hospital Colorado, we strive to get patients back where they belong: home. And while the outcomes for our patients consistently meet or exceed national benchmarks, our work is far from done.

Our commitment to continually raising the standard of kidney care makes research and innovation a vital part of what we do. We collaborate with other disciplines and institutions to share data, identify best practices and improve approaches to care.

Dr. Nicholas Cost working with young girl
Research article

Rare diseases and cancers are often difficult to study because there are not enough cases. Learn about studies conducted on pediatric RCC.

Pediatric nephrology advancements

All our physicians and nurses are involved in collaborative research with providers from the Department of Pediatric Surgery. Together, they examine immunosuppression regimens and outcomes in pediatric renal transplantation. We're proud to report that our kidney transplant outcomes are among the best in the nation.

"The frequency and early occurrence of acute kidney injury reinforces the need for systematic surveillance and study when patients are admitted to intensive care."
Danielle Soranno, MD

What our kidney research means for kids

Scientists in our Kidney Center have many research interests spanning a broad range of basic science and clinical areas. These projects include the study of renal conditions, such as renal salt and water handling, autosomal dominant polycystic kidney disease (ADPKD), congenital nephrogenic diabetes insipidus (NDI), growth failure in chronic kidney disease, nephrotic syndrome and focal segmental glomerulosclerosis, and pediatric renal transplantation.

Our current research

Acute kidney injury (AKI) can occur among critically and non-critically ill hospitalized pediatric patients, most commonly as a result of decreased renal perfusion or nephrotoxic drug exposure. AKI can also lead to increased mortality and length of stay (LOS) in critically ill patients.

A research team including Danielle Soranno, MD, Justin Searns, MD, and Katja Gist, MD, conducted a multicenter retrospective cross-sectional analysis of patient data from 34 children’s hospitals to determine if AKI was associated with changes to LOS for commonly encountered pediatric diagnoses among children with and without ICU-level care. Researchers found that development of AKI was associated with longer LOS and increased exposure to nephrotoxic medications among all pediatric patients.

Read the study “Impact of Acute Kidney Injury and Nephrotoxic Exposure on Hospital Length of Stay”

Co-led by Children's Colorado's Jens Goebel, MD, the Improving Renal Outcomes Collaborative (IROC) invites pediatric hospitals nationwide to share data about patients. Together, we can learn from each other and implement consistent practices to improve the outlook for children with complex kidney disease.

"Our pie-in-the sky goal is that children with a kidney transplant will do just as well as completely healthy children," says Dr. Goebel.

Nearly one in four kids will sustain acute kidney injury during a stay in intensive care. That’s why our multidisciplinary Pediatric Kidney Injury and Disease Stewardship (PKIDS) Program is designed to study and prevent acute kidney injury in intensive care units and across our hospital. The program brings together specialists from pediatric nephrology, neonatology, and cardiac and pediatric intensive care.

We're actively working on several research and data-gathering efforts hospital-wide. Our projects include:

  • Neonatal intensive care: Ischemic kidney injury often results from hypoxia at birth. Using urine biomarkers like NGAL, our team is working to identify and stop the progression of kidney injury sooner.
  • Pediatric intensive care: By correlating continuous renal replacement therapy (CRRT) machine data with electronic medical record data, the team seeks to predict and avert problems with CRRT circuit life.
  • Cardiac intensive care: The drug milrinone — standard after heart surgery to increase the heart's contraction strength and reduce vascular resistance — can injure some patients' kidneys. Our team has identified two biomarkers that may predict impaired clearance of the drug, which could help guide care and avert injury.
  • Hospital-wide: Our team recently rolled out an automatic electronic health record surveillance program that flags all patients within the hospital exposed to nephrotoxic medications. This is part of our effort to reduce kidney injury across the board.

The principal investigators include:

Jens Goebel, MD, in conjunction with multiple institutions nationwide, pioneered research to identify and treat a complication of bone marrow transplantation, called thrombotic microangiopathy (TMA). This condition creates rough and irregular linings in the kidney's blood vessels, causing inflammation. Once TMA is diagnosed, it responds well to the drug eculizumab, which is an infusion that helps reduce the inflammation.

Dr. Goebel and his team take a multidisciplinary approach to bring more awareness to the risk patients face of developing TMA after a bone marrow transplant.

Stay informed