2023 Department of Pediatrics Academic Annual Report

Pediatric Nephrology

PEDIATRIC FACULTY Dr. Daniel Feig..........................................................Director | Professor Dr. David Askenazi...............................................................Professor Dr. Erica Bjornstad..............................................Assistant Professor Dr. Kyle Deville.....................................................Assistant Professor Dr. Sahar Fathallah-Shaykh................................................Professor Dr. Michael Seifert................................................................Professor Dr. Tennille Webb................................................Assistant Professor

FEATURED RESEARCH The UAB Division of Pediatric Nephrology leads research efforts in drug discovery and pharmacokinetics as well as the assessment, progression and treatment of acute and chronic kidney disease in children. THE PEDIATRIC AND INFANT CENTER FOR ACUTE CARE NEPHROLOGY The Pediatric and Infant Center for Acute Care Nephrology (PICAN) led by David Askenazi, M.D. PICAN seeks to understand and improve outcomes in neonates and children who are at risk for acute kidney failure. Over the past several years, we pioneered the use of an adapted machine (Aquadex) at UAB and Children’s of Alabama to treat neonates and premature infants with kidney failure who were too small for conventional hemodialysis. The team has published single-center and multi-center reports on the use of this therapy in neonates and small children. As a result of this work, children as small as 1 kg can now receive this lifesaving therapy. With the publication of these results, this technology is now being used at more than 10 major children’s hospitals across the country, including Cincinnati Children’s Hospital Medical Center, St. Louis Children’s Hospital, Children’s Hospital of Philadelphia and Seattle Children’s Hospital. Children’s of Alabama remains the premier location for national referrals for management of kidney failure in premature infants <2.5kg in birth weight. The ongoing WE ROCK (Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease) and VIOLET study of new dialysis machines for renal replacement therapy in neonates, both led by Tennille Webb, M.D., are aimed at taking the next technological steps in dialysis of our smallest and most vulnerable patients. The PICAN and Dialysis Team reached a landmark in 2023 in that we have now treated pediatric ICU patients for 10,000 days of continuous (24/hr/d) renal replacement therapy using the Aquadex and PrisMax devices. This includes care for nearly 600 patients from 10 Southern states. Dialysis removes dangerous waste products, excess electrolytes and excess fluid but also clears necessary nutritional components from the circulation that must be replaced. To better understand this process and improve the growth and developmental outcomes of infants with kidney failure, Dr. Webb leads the MINI-ROCKET (Multicenter Investigation of Neonatal and Infant Nutrition and Outcomes in Continuous Kidney Replacement Therapy) Study. To help disseminate our success to other institutions, Dr. Askenazi launched the NICKS (Neonatal and Infants Course in Kidney Support). This two-day course, repeated three times annually, instructs pediatric nephrologists and dialysis teams, including nurses, nurse practitioners, pharmacists and nutritionists, to provide optimal renal care for our smallest patients. More than 400 physicians and nurses from 38 US states and 20 countries have participated in this course. Dr. Askenazi worked with other faculty at UAB to develop the Zorro-Flow, a novel external urine collection device for neonates. This device, which collects urine without the need for invasive catheterization, can reduce pain, procedural injury and risk of infection among infants in the neonatal intensive care unit. The development of this device is now supported by funds from the NIH Small Business Innovation Research (SBIR) program. CAN-U-P-LOTS is a collaboration between Dr. Askenazi, one of our renal fellows, Lindsey Gordon, M.D., and one of our neonatologists, Dr. Christine Stoops. This is our latest major quality-improvement project in the NICU, aimed at decreasing the morbidity and mortality associated with kidney injury among premature infants.

2023 Academic Annual Report

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