Nephrology

Dr. Scott E. Wenderfer,  Division Head

Mandate

The Division of Nephrology promotes the health of children living with kidney disease through excellence in clinical care, clinical and basic research, education, and advocacy. Our mission is to deliver state of the art care in accordance with Coast Salish teachings, by defining clinical benchmarks and developing evidence-based clinical pathways. We strive to enhance care by defining unmet needs and through systems innovation, quality improvement, and translational collaborative research. We integrate our research into clinical care, and we promote equity of care across the province through community partnerships and regional outreach clinics.

Our Kidney Care Program has evolved into dedicated programs in General Nephrology, Chronic Kidney Disease, Dialysis, and Kidney Transplant, each with their own multidisciplinary teams and Medical Directors.

UPDATED Feb 10 2025
 
 
 
 

The Division of Nephrology is engaged in a number of important research initiatives, including outcomes research in neonatal and pediatric acute kidney injury, in babies born with congenital kidney malformations, and in children and adolescents after kidney transplantation. Our faculty study the role of hypertension and patient reported outcome measures in the maintaining kidney health in children, the role of autoantibodies in pediatric lupus nephritis, the factors that impact the natural history of nephrotic syndrome, and the interventions that best improve transitions in care to adult providers. We seek to discover and validate non-invasive markers of rejection in kidney transplant patients, relapse of glomerulonephritis and nephrotic syndrome, and kidney injury in renal vasculitis.

In that regard, members of the Division are local, national, and international leaders in their areas of research. We are actively engaged in multicenter collaborative efforts including the Pediatric Nephrology Research Consortium (PNCRC), the North American Pediatric Renal Trials and Collaborative Studies (NAPRTCS), neonatal and pediatric intensive care consortia for the study of acute kidney injury (AWARE, AWAKEN), national and international collaborations for glomerulonephritis, nephrotic syndrome, chronic kidney disease, and hypertension (CKiD, KDIGO, PRO-Kid, STOPP), the identification of biomarkers in kidney transplantation (PROBE), and national collaborations including the Canadian National Transplant Research Program, the Can-SOLVE CKD Network. Division members have been site-investigators for sponsored and investigator-initiated clinical trials in chronic kidney disease, atypical hemolytic uremic syndrome, nephrotic syndrome, lupus nephritis, and kidney transplantation.

In support of their research, Division members have received operating grants and financial support from the Canadian Institutes of Health Research, the Kidney Foundation of Canada, the National Institutes of Health, the Dean of Medicine and Establishment Awards, the Children’s Hospital Foundation Telethon, the Clinic Research Capacity Building Award from the BC Children's Hospital Research Institute, as well as training grants from the National Science and Engineering Research Council and the NephCure. The Division continues to provide elective and research training to undergraduate and postgraduate students.

To learn more about our Nephrologists and their research work, please visit https://www.bcchr.ca/nephrology

The Division is actively involved in UBC undergraduate medical school teaching and postgraduate medical education as an integral component of the nephrology outpatient teaching experience. All pediatric residents participate in a combined ambulatory and inpatient nephrology rotation, typically in their second year of training. This rotation is designed to give residents experience in out-patient Nephrology as well as in-patient/ on-call subspecialty care. There are five half-day clinics per week including general nephrology, chronic kidney disease, nephrotic syndrome, hypertension, and kidney transplant clinics. When not in clinic seeing patients, residents use the time for clinical documentation, reading, preparing presentations, or attending scheduled rounds. One week of the elective the resident will be assigned to the in-patient/ on-call service. During this time they will be responsible for rounding on ward patients, seeing consults on wards and in the ED, and taking first call for ward issues. At the end of their rotation, the resident will also be required to present in-patient cases to the division. There is also an additional elective that residents can use to gain additional experience in one or more of our specialty services. Both the rotation and the elective have consistently been highly rated.

The Division of Nephrology also offers an accredited Royal College of Physicians and Surgeons training program in Pediatric Nephrology. Full training in Pediatric Nephrology is achieved by a program of graded responsibilities and learning experience which fulfill the central roles of medical expert, communicator, collaborator, manager, health advocate, scholar and professional, necessary to the specialist. The first clinical year is structured to provide exposure to the whole range of nephrology: hemodialysis, peritoneal dialysis, transplantation, renal pathology, fluid and electrolyte management and general consultative nephrology. The second year is dependent upon the resident’s goals. There are appropriate support facilities and personnel to ensure there is a breadth and depth of exposure: laboratory and pathology rotations are excellent, radiology and nuclear medicine interaction occur frequently both formally and at uroradiology rounds. An optional third year is recommended for those trainees interested in pursuing a career in academic medicine. We offer trainees an opportunity to work and train within a large, diverse and well staffed series of multi-disciplinary clinics with health professionals from a variety of fields, including social work, dietitians, pharmacists, psychologists, dedicated transplant and dialysis nurses, ethicists, and related subspecialists. All fellows or trainees are expected to perform a research project during their time in the program and many have chosen to pursue further research training under mentorship within or outside the division. Our recent trainees have been involved in a number of varied clinical research projects, with multiple presentations at major meetings, and publications in peer-reviewed Nephrology journals.

To inquire about our fellowship program, please call 604-875-2272

Members of the Division hold cross-appointments in UBC graduate studies programs and are available to provide supervision of graduate and postgraduate medical science trainees.

Division members participate in a number of Nephrology teaching rounds including weekly inpatient service rounds, weekly combined urology/radiology/nephrology rounds, bimonthly service-line rounds, monthly journal clubs, monthly research-in-progress sounds, monthly kidney biopsy rounds, annual Pediatric Grand Rounds, Pediatric resident academic half days, Nephrology fellow academic half days, and Departmental Advances in Pediatrics.

There have been many achievements in the Division’s Clinical Care Program over the years, including the assembly of highly skilled multidisciplinary teams of specialty clinic physicians, nurses, dietitians, pharmacists, and social workers, the establishment of specialty out-patient clinics, and the evolution of a shared care model of practice. To enable its clinical, educational, and research missions, the Division moved to a Shared Care Program in which clinics are attended by more than one physician, and where patient care is consultative, collaborative, and shared. The physician on service and/or on call attends to the care of the hospitalized patient. Additionally, in order to gain efficiencies in care, to improve outcomes, and to enhance teaching and education, specialty Nephrology clinics have been developed. There are presently a number of half-day clinics offered per week, including dedicated clinics for chronic kidney disease, kidney transplant, general referrals, nephrotic syndrome, hypertension, and a combined renalrheumatology clinic.

The ambulatory care clinics see approximately 2000 visits per year. Of these, 1200 visits are follow-up evaluations in the General Nephrology clinics with approximately 350-400 new referrals annually. Within this group we have recently developed dedicated clinics for the care of our children with nephrotic syndrome (75-100 active patients), hypertension, and a combined renal-rheumatology clinic. Our Chronic Kidney Disease clinics provide care for approximately 150 children identified as having decreased kidney function (< 60 ml/min/1.73m2) but not requiring dialysis. Our Kidney Transplant clinic is the model upon which the Multi Organ Transplant clinic has been built. It sees approximately 350 visits per year and serves a population of approximately 50 active patients.

Our Dialysis program offers both hospital and home-based therapies. Our hospital-based hemodialysis unit provides over 1000 dialysis treatments for approximately 6 children per year, in addition to providing hemodialysis treatment support to the Pediatric Intensive Care Unit. We have a dedicated state of the art pediatric hemodialysis unit, which will be relocated to the third floor of the new TECK Acute Care Building of the Children’s Hospital. Our home-based dialysis program provides care for up to 15 children on peritoneal dialysis. The Chronic Kidney Disease, Transplant, and Dialysis programs are resource-intensive and are staffed by highly skilled multidisciplinary care teams with dedicated Medical Directors.

To learn more about our Renal Program and our clinic, please visit: http://www.bcchildrens.ca/our-services/clinics/renal-program.

Quality

The Quality Program of the Division incorporates best practices and responds to all incidents of harm. It sets and prioritizes Divisional quality improvement, patient safety, and, in conjunction with the Nephrology Clinical Pathway Development Committee, clinical pathway objectives and goals. It was developed to identify and address potential/actual issues that affect the quality of care delivered including assessments provided by the Nephrology clinical care teams. It has a responsibility to communicate the results/recommendations of the review activities to all clinical team members, to recommend changes to practice and assist with implementation of changes, to ensure quality, safety, and clinical pathway improvement strategies and initiatives are implemented, evaluated and sustained, and to report on the quality of service provided in the Nephrology programs. The Quality Director reports directly to the Division Head of Nephrology and regularly to Division members through the Division Meeting which occurs at least 4 times per year. The Division Head then reports to the Child Health Quality of Care Committee as required.

With a commitment to quality and excellence in clinical care, the Division of Nephrology’s Clinical Pathway Development (CPD) Team was established to help transform established best practices and innovative research findings into standardized clinical care and improved patient outcomes. The CPD Team endeavours to elevate the patient care experience by empowering pediatricians, primary care physicians, allied health practitioners, and patients and families themselves, with cutting edge knowledge, exceptional care, and uncompromised quality. The overarching goal of the Clinical Pathway Development Team is to ensure the health, safety and well-being of the patients and families cared for by the Division of Nephrology. Underpinning this goal is the CPD Team’s commitment to continuing education, change management, knowledge translation, quality improvement, and clinical research. More specifically, the CPD aims to: (1) critically review available evidence; (2) establish consensus and make evidence based-recommendations for practice in the form of clinical pathways; (3) develop the necessary tools and resources needed to support the effective education, dissemination, and evaluation of the pathways; (4) audit end-user fidelity to and satisfaction with the pathways; (5) iteratively re-evaluate and update the pathways as new evidence becomes available, and; (6) support ongoing research initiatives in the fields of clinical pathway theory and pediatric nephrology.

Since its inception in 2011, an important focus of the CPD Team has been the evolution of the Childhood Nephrotic Syndrome (CNS) Clinical Pathway – a structured, evidence-based, and prescriptive care plan detailing the essential steps to be taken by various care providers for the management of children with nephrotic syndrome. Numerous resources and programs have been produced as part of the CNS Pathway. Collectively, these resources have allowed for highly efficient patient care, uniquely broad yet focused learning opportunities for students and trainees, and increased adherence to CNS Pathway recommendations by health care practitioners and patients themselves. Moreover, the CPD team continues to share and promote the CNS Pathway at local, national, and international forums. A guiding modus operandi for the CPD Team has been to push current practices towards, and indeed beyond, the best-available standards. To this end, future directions of the CPD Team include not only the progression of the CNS Pathway, but also the development of unique pathways for the other renal conditions typically seen within the Division of Nephrology, including but not limited to hypertension, childhood glomerulonephritis, and congenital kidney anomalies diagnosed in the antenatal period.

For more detailed information on our patient care programs, please visit: http://www.bcchildrens.ca/our-services/clinics/renal-program

Regional Care

In conjunction with Child Health BC and the local heath authorities, the Division of Nephrology continues to develop and promote regional care for children with kidney disease and their families throughout British Columbia.  The regional care program has dedicated resources supporting a pediatric nephrology specialty nurse, dietitian, and clerk. Regions served by a Pediatric Nephrology clinic include the Fraser Health Authority at the Surrey Memorial Hospital, the Northern Health Authority at the University Hospital of Northern British Columbia in Prince George, and clinics are now being developed in the Interior Health Authority to operate out of Kamloops and Kelowna.

Faculty:
Scott E. Wenderfer, MD, PhD, FASN (Division Head)
Robert Humphreys, MD FRCPC (Fellowship Program Director)
Allison Eddy, MD, FRCPC (Scientific & Research Staff)
Douglas G. Matsell, BSc, MDCM, FRCPC
Tom Blydt-Hansen, MDCM, FRCPC
Janis Dionne, MD, FRCPC
Eleonora Jugnauth, MD, RFCPC (Kelowna based Nephrologist)
Cherry Mammen, MD, MHSc, FRCPC
Matt Harding, MD, FRCPC (Victoria based Nephologist)
Mina Matsuda-Abedini, MD, FRCPC
Susan Samuel, MD, FRCPC
Blake Sandery, MBBS, MMed, FRACP

Nurses:
Lorraine Paz, Clinical Nurse Leader
Adam Nelle-Bouton, Clinical Nurse, Hemodialysis and Peritoneal Dialysis
Bianca Nguyen, Clinical Nurse Clinician, General Nephrology and Outreach
Carly Lecuyer, Hemodialysis Nurse
Daria Juck, Clinical Nurse, Hemodialysis and Peritoneal Dialysis
Jennifer Leechik, Renal Nurse Clinician, Peritoneal Dialysis
Jessica Sampaio, Transplant Nurse Clinician
Jessie Ahuja, Transplant Nurse Clinician
Joane Rico, Clinical Nurse, Hemodialysis and Peritoneal Dialysis
Kathleen Smiley, Hemodialysis Nurse
Kim Lobo, Clinical Nurse Clinician, Chronic Kidney Care Clinic
Laura Griffiths, Clinical Nurse Clinician, General Nephrology and Outreach
Leslie Haynes, Hemodialysis Nurse
Lorraine Paz, Hemodialysis Nurse
Marijana Kraljevic, Transplant Nurse Clinician
Rupinder Toor, Clinical Nurse Clinician, General Nephrology and Outreach (on leave)
Sarah Fay, Transplant Nurse Clinician
Tania Ferraro, Clinical Nurse Coordinator

Nephrology Fellows:
Asim Almotawa, MD
Karma Abukasm, MD
Laura Hyo-Sun Kim, MD
Simple Kakar, MD

Social Workers:
Amy Mcatavey
Losefina Para
Rachel Chui
Sylvia Dai (on leave)

Dietitians:
Elizabeth Leung, RD
Kirsten McFadyen, RD
Nonnie Polderman, RD
Natalie Sousa, RD

Pharmacists:
Katie Haubrich, BPHARM, PharmD
Laura Beresford, BPHARM, PharmD

Art Therapist:
Nicki Elischer

Psychologist:
Anisha Varghese, PhD, R Psych

Child Life:
Christy Lowey
Rita Marchildon

Research Staff:
Amy Thachil, Research Assistant, Transplant
Bhavana Gourish, Research Assistant, Transplant
Isabella Parrotta Research Assistant, Transplant
Linda Li, Research Assistant, Transplant
Marie-Noelle Wharton, Clinical Research Coordinator
Marisa Catapang, Research Coordinator
Michelle Sutjitro, Senior Administrative Coordinator
Monica Ho, Research Coordinator, Transplant
Phillip Ly, Research Assistant, Transplant


Administrative Services:

Alice So, Administrative Secretary
Chen (Ivy) Leong Liu, Multi-Organ Transplant Clinics
Cheuk (Emma) Lau, General Nephrology Clinics
Jovelle Jimenez, Renal Outreach Clinics
Kathryn Garcia, Renal Dialysis Unit (RDU) Clerk
Kim Wheatley, General Nephrology Clinics
Lani Coloma, Multi-Organ Transplant Clinic, Pre-Transplant
Ma (Eliza) Inocencio, Multi-Organ Transplant Clinics
Miranda Wall, Multi-Organ Transplant Administrative Clerk
Susan Harkins, General Nephrology Clinics
Theresa Wong, Chronic Kidney Care Clinic (CKCC)

Fellowship Program:
Robert Humphreys, MD FRCPC, Fellowship Program Director
Division of Nephrology
4480 Oak St., BCCH
Vancouver, BC V6H 3V4
Telephone: 604-875-2272
Fax: 604-875-3649
Email

Contact:
Division of Nephrology
4480 Oak St., BCCH
Vancouver, BC V6H 3V4
Telephone: 604-875-2272
Fax: 604-875-3649