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Nephrology

Cystic Kidney Disease Program

Overview

The Division of Pediatric Nephrology at Floating Hospital for Children in Boston is made up of a team of specialists that provide care for the range of cystic kidney diseases. Our team is dedicated to providing your child with the best possible care, so that he or she can get back to being a kid.

Cystic kidney disease occurs when a cyst or clusters of cysts develop in the kidneys. These cysts are abnormal, closed sacs that may contain fluid, air or semi-solid materials. The major cystic kidney diseases that we treat are Hereditary Polycystic Kidney Diseases, simple renal cysts and diseases with other causes, including issues with the glomeruli.

Hereditary polycystic kidney diseases

Hereditary Polycystic Kidney Disease (PKD) occurs in individuals with PKD disease known to run in the family but also in those where new mutations arise.

Autosomal Dominant Polycystic Kidney Disease (AD-PKD)

To treat AD-PKD, our pediatric nephrologists not only follow the formation of cysts and development of renal insufficiency/failure but also carefully monitor and treat any proteinuria and/or hypertension that develop in children with this disease.  Patients with AD-PKD are also at risk for number of other issues. For example, your child may be at greater risk for infections of the kidneys/cysts as well as kidney stones. To try and alleviate this risk, we monitor your child’s progress throughout his or her time in our care. 

In some cases, we may refer your child  to cardiology as there are a few congenital cardiac malformations associated with AD-PKD.  Also, when there is a concern for brain aneurysms, which can be associated with AD-PKD, we will monitor your child by using advanced imaging technologies. If any of these complications should occur in your child, you should rest assured that we will be there with you every step of the way and help coordinate your child’s care.

Autosomal Recessive Polycystic Kidneys (AR-PKD)

For those with AR-PKD, our pediatric nephrologists work closely with the Division of Pediatric Gastroenterology at Floating Hospital, as this disease commonly also affects the liver.  In addition, we work with a team of genetic doctors who can be helpful with genetic counseling in future family planning for the parents of our patients.

Simple renal cysts

Many infants and children are found to have simple renal cysts noted either during the prenatal ultrasound or on other radiologic studies, possibly obtained as part of a work up for something else entirely.  Most of the time, these cysts do not cause people harm, however, we will perform serial renal ultrasounds to ensure that further cysts do not develop. Very rarely, these cysts may bleed and cause pain or become infected.

Other causes of cystic kidneys

Cysts in the kidneys may arise from the filtering units of the kidney called glomeruli.  Often times, as the renal disease progresses, more cysts develop, not only destroying the filtering capability of the glomeruli but also affecting the surrounding structures of the kidney.  We carefully follow these patients for all of the problems that arise with renal insufficiency/failure.

Doctors + Care Team

Lawrence S. Milner, MD

Lawrence S. Milner, MD

Title(s): Chief, Division of Pediatric Nephrology; Professor, Tufts University School of Medicine
Department(s): Pediatrics, Pediatric Nephrology
Appt. Phone: 617-636-7429
Fax #: 617-636-0066

Renal failure, acute and chronic, glomerular disease (especially urine microscopy), liver related renal disease, hypertension, urinary tract infection, fluid and electrolyte imbalance, acute dialysis (peritoneal, hemodialysis and hemofiltration), transplantation

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Julie Nicoletta, MD, MA

Julie Nicoletta, MD, MA

Title(s): Pediatric Nephrologist; Assistant Professor, Tufts University School of Medicine
Department(s): Pediatrics, Pediatric Nephrology
Appt. Phone: 617-636-7429
Fax #: 617-636-0066

Hematuria, proteinuria, hypertension, renal insufficiency, kidney stones, fluid and electrolyte imbalance

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To make an appointment with one of our expert Pediatric Nephrologists, please call 617-636-8100.


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