Next Level Kidney Care: The New Glomerular Disease Center

Glomerular disease can threaten our health by damaging glomeruli, tiny filters within kidneys that remove waste and fluid from blood. This condition can lead to a range of complex kidney problems that comprises protein and blood in urine, high blood pressure, kidney dysfunction and edema (swelling of the body). Glomerular disease can be devastating, leaving a long-term impact on a child’s adult life. Children with the disease need long term follow-up care into adulthood since their disease tends to have relapses with need for ongoing treatment.

Our new Glomerular Disease Center, co-led by Michelle Denburg, MD, MSCE, and Madhura Pradhan, MD, MBBS, offers a combined pediatric and adult nephrology evaluation for adolescents and young adults with glomerular diseases. The goal is to include nephrologists from University of Pennsylvania (PENN) at least three years prior to a patient’s transition into adult care. This approach allows clinicians to better understand patient background and disease history, address patient concerns and challenges associated with the transition of care, and collaborate with peer experts to determine appropriate and personalized care plans. The center also provides second opinions for children above age 13 and offers the expertise of a renal pathologist who review their kidney biopsies.

The center currently sees 500 active children, adolescents and young adults with glomerular disorders. This new center for transitional care transforms the gold standard of glomerular disease treatment. While centers of excellence in glomerular diseases exist around the country, CHOP’s Glomerular Disease Center is a one-of-a-kind collaboration between pediatric and adult nephrologists, as well as a renal pathologist for biopsy review.

Dr. Denburg also co-leads the Glomerular Disease Learning Network (GLEAN), a collaborative with eight other pediatric health systems. Its mission is to improve the health and well-being of children with glomerular disease by conducting and integrating multi-institutional research and quality improvement (QI). GLEAN has several active research projects and QI initiatives.

The Glomerular Disease Center’s clinic is located within CHOP’s Buerger Center for Advanced Pediatric Care. In addition to the compassionate and comprehensive care for which CHOP is known, the center provides these special medical offerings:

• Genetic and other specialized testing, such as testing of the alternative complement pathway
• Clinical trial enrollment, including those for new therapies
• Infusions arranged in Day Medicine
• Consultation with registered dieticians and social workers
• Engagement with family support and kidney research advocacy groups
• Specialized interpretations of prior kidney biopsies by CHOP renal pathologists

This combined clinic with CHOP- and PENN-credentialed pediatric and adult nephrologists is a unique patient-centered care model that we hope to expand to other patient populations within nephrology, and to those with chronic diseases across medical specialties at both hospitals.