Lurie Chicago Children’s Hospital Expands 24/7 In-House Dialysis Nursing Coverage

Ann and Robert H. Lurie Chicago Children’s Hospital’s fully hospital-owned and -operated ADAPT program offering round-the-clock coverage was created in 2022, replacing an outsourced program, and recently expanded.

“24/7 in-house pediatric dialysis coverage is a relative rarity and truly affords our pediatric patients immediate access to a range of therapies, administered by specialty-trained pediatric nurses,” Mahima Keswani, M.D., medical director of dialysis and attending physician in nephrology at Lurie Children’s, said in an emailed response to questions from Managed Healthcare Executive.

Keswani, who also is an assistant professor at Northwestern University’s Feinberg School of Medicine, said that round-the-clock dialysis nurse coverage — which might be expected to be costly — “has been made possible by following a similar model of shift-based nursing care, where nurses work in shifts to provide continuous access to timely care.”

The ADAPT Program’s innovative staffing model has enabled Lurie Children’s to ensure that every child gets the right therapy at the right time, according to a Feb. 25, 2025 news release.

The program is led by both Keswani and Theresa Mottes. The head of Lurie Children’s Division of Nephrology is Priya Verghese, M.D., M.P.H.

The division performed 3,543 acute dialysis procedures and 44 kidney transplants in 2024 — the most of any pediatric transplant program in the United States — and is one of the top pediatric programs in the country, according to the release.

“With patient volumes growing and more pediatric-specific therapies now available on the market, we saw this as a timely opportunity to bring our program internal, allowing us to be a more nimble, therapeutic care team,” Keswani said in a Nov. 18, 2022, new release that was quoted in this more recent one.

The ADAPT Program offers several types of treatment, including hemodialysis, continuous renal replacement therapy, peritoneal dialysis, and plasmapheresis.

Some children receive a preemptive kidney transplant before they start dialysis.

About one-third of the kidneys transplanted into children are from living donors, according to the National Institute of Diabetes and Digestive and Kidney Diseases. A kidney from a parent is more likely to be a better match than a kidney from someone who is not related to the child.

A child older than 2 can generally receive an adult kidney, according to Stanford Medicine Children’s Health. There is usually enough space in the child’s abdomen for the new, adult kidney to fit, the Stanford healthcare system says on its website.