Alder Hey Children’s Hospital is a 300-bed specialist paediatric centre, providing local services for the children of Liverpool and tertiary referral services for Merseyside, West Lancashire, Cheshire, North Wales, Anglesey and the Isle of Man (regional population approximately 3.1 million). All major paediatric medical and surgical specialties are represented within the hospital.
The department of paediatric nephrology provides services for infants and children with the full range of renal problems, including congenital abnormalities, urinary tract infection, renal stone disorders, hypertension, nephrotic syndrome, glomerulonephritis, vasculitis, inherited renal conditions, tubular disorders, acute renal failure and chronic / end-stage renal failure.
As well as medical staff, the renal multi-disciplinary team is comprised of ward nurses, specialist dialysis nurses, transplant nurse practitioner, renal dietitian, pharmacist, clinical psychologist and hospital play therapists. We work closely with surgical colleagues in the department of urology to provide integrated treatment for patients with complex urinary tract abnormalities. We also provide support for renal problems arising in children under the care of other teams, particularly the intensive care unit, cardiology, rheumatology and oncology.
In-patient renal facilities are based on a 12-bed ward (shared with rheumatology). There is a separate day-case unit with haemodialysis and peritoneal dialysis support facilities. Renal out-patient clinics are held 3 times per week at Alder Hey. The consultant nephrologists also hold joint out-patient clinics with local paediatricians in a number of district general hospitals throughout the region, to support local provision of services for children.
The Alder Hey renal unit was among the first in the UK to offer dialysis to children with renal failure (haemodialysis from 1968 and peritoneal dialysis from 1973/74). The renal transplant service commenced in 1977/78. Since the early 1990’s, Alder Hey has collaborated with Royal Manchester Children’s Hospital and Manchester Royal Infirmary in a supra-regional paediatric renal transplant programme. Preparation for transplantation is carried out at Alder Hey, with transplant surgery performed in Manchester. After completion of post-operative in-patient care, patients return to Alder Hey for ongoing renal transplant management (usually about 2 weeks after the transplant operation).
Patients with long-term renal problems generally transfer to adult services at 16 – 18 years of age, depending upon individual needs. The Alder Hey unit has links with several adult nephrology units to facilitate transfer for continuing care.