Disorders Are Growing Concern in Eastern North Carolina By Hsiao L. Lai, M.D.; Basema Dibas, M.D.; and Guillermo Hidalgo, M.D.
Pediatric patients with nephrologic disor-
inherited or developmental disorders to-
ders are a unique population with com-
ward an increasing proportion of children
plex medical needs who often require
referred for primary hypertension, renal
specialized dietary, social, financial and
hyperfiltration and metabolic syndrome.
educational support services.
These children are at much higher risk of developing diabetes and progressive
Many of these patients have underlying
developmental or genetic disorders, in
Dr. Guillermo Hidalgo, Dr. Hsiao Lai and Dr. Basema Dibas are pediatric nephrology specialists with ECU. Dr. Hidalgo is a boardcertified pediatrician and associate professor. He can be reached at (252) 744-5437 or email@example.com. Dr. Lai is board certified in internal medicine, pediatrics, nephrology and pediatric nephrology and an assistant professor. She can be reached at (252) 744-2545. Dr. Dibas is board certified in pediatrics and a clinical assistant professor. She can be reached at (252) 744-5437.
addition to their kidney disease, which
Eastern North Carolina has a particularly
warrant multidisciplinary care. In the
high burden of diabetes, hypertension
past, dysplastic and developmental dis-
and obesity. This affects not only the
betes in the 22-40 year-old age group are
orders of the kidney and urogenital tract
accelerating, while stable or declining in
were the leading causes of kidney disease
these disorders are being discovered in
all other age groups, aside from patients
that progressed to end-stage renal disease
adolescents and school-age children.
75 years or older.
According to the National Health and Nu-
The true prevalence of patients with
Recently, the spectrum of pediatric renal
tritional Examination Survey (NHANES),
kidney disease is unknown. Because of
disease has changed from predominantly
the rates of incident ESRD related to dia-
this, it is difficult to accurately estimate
how many of these individuals progress to advanced stages of chronic kidney disease (CKD) or to kidney failure. Young patients with kidney disease suffer high morbidity and mortality, especially if there is a delay in disease detection. Fortunately, new standardized equations for
in children is allowing the medical community to better detect and monitor early kidney disease in a more uniform fashion. Pediatric nephrology in eastern North Carolina has been a presence since 1983. Between 1983 and 2003, there was a sustained patient base of about 800 patients. Although in general pediatricaged patients comprise only about
The Eastern Physician
The Eastern Physician March 2012