Children needing dialysis

Larry Greenbaum

Caring for children

Children needing dialysis

Acting on medical necessity

An abrupt change in scenario

Last year the Emory pediatric transplant program at Children’s Healthcare of Atlanta performed more pediatric kidney transplants than any institution in the United States. However, transplant is not appropriate for all children, and those ineligible for transplant face a lifetime of dialysis.

Emory-Children’s Center (ECC) provides chronic dialysis each year to more than 40 children, from newborns to teenagers. Since ECC has the only pediatric dialysis unit in Georgia, it is the only place in the state where very young children can receive chronic hemodialysis. Some families commute more than five hours three days a week.

About 55% percent of the children seen in the dialysis unit at ECC have Medicaid, while 10% have no insurance whatsoever. Emory nephrologist Larry Greenbaum doesn’t know which of his young patients have coverage. What he does know is that they all have life-or-death dependency on the machines that remove toxins from their blood, work that their own malfunctioning kidneys can’t do. Without dialysis, most would survive no more than five or six days. Greenbaum and his colleagues engage in research to improve care for these children, including studies assessing the poor growth and bone weakness by which many are affected.



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