National Kidney Month Q&A with Julie Goodwin, MD

We provide care for a comprehensive spectrum of kidney disorders in patients from birth-21 years of age which includes management of acute and chronic electrolyte disorders, acute and chronic kidney failure, various forms of kidney inflammation (glomerulonephritis), high blood pressure, kidney stones, inherited kidney diseases, and urinary tract abnormalities. We manage children on dialysis and also have an active kidney transplant program. We provide consultation for hospitalized patients and also see patients in the outpatient (clinic) setting.

The kidneys have three main functions: to maintain our hydration (volume) status, to remove waste/toxins from our bodies and to regulate blood pressure. They also contribute to bone health and red blood cell production. To accomplish these tasks, the kidneys continually clean our blood through millions of tiny filters called nephrons, removing the excess fluid and waste that becomes urine.

Drink plenty of water and eat a diet high in potassium (fruits and veggies!) and low in sodium. Maintain a healthy weight and avoid smoking. Get plenty of aerobic exercise. Optimally manage any underlying conditions such as high blood pressure or diabetes.

I was fascinated by the physiology of the kidneys and the ways they impact the health of the whole body, and by the same token, the ways sick kidneys often cause multi-system impairment.

Nephrology is a field that has a nice mix of inpatient and outpatient time, allowing involvement with some of the sickest hospitalized patients but also facilitating rewarding long-term relationships with patients over many years. I’ve been in practice long enough that some patients I took care of as infants as now graduating from college! That is really rewarding.

The research side of nephrology is equally engaging as mechanistic insights into the ways kidneys function in health and disease can inform other disease process, often throughout the lifespan, not just in childhood.

Kidney disease is often asymptomatic until it becomes very severe, but certain complaints may indicate a kidney problem and should prompt investigation. These could include progressive fatigue, change in urinary habits, whole-body swelling, headaches, increasing blood pressure, or persistent itching.

We see outpatients at Yale New Haven Children’s Hospital Pediatric Specialty Centers in Greenwich, Norwalk, Trumbull, New Haven and Old Saybrook. We manage hospitalized patients in New Haven but are available for telephone consultation at any network hospital (Bridgeport Hospital, Greenwich Hospital, Lawrence + Memorial Hospital) or anywhere in the state through Y-access.