Why Families Turn to UCSF for Complex Kidney Disease in Children

"Your child has a rare kidney disease." For families, those words mark the beginning of a difficult journey. A child with a rare kidney disease can need five specialists — five separate clinics, five appointment schedules, five medical teams who may have never met.

The UCSF Division of Pediatric Nephrology offers a more straightforward path. The division has built specialized clinics where they lead multidisciplinary teams in coordinated visits. Families receive comprehensive assessment and unified treatment planning in one place, rather than spending months piecing together care across disconnected appointments.

Consistently ranked in the Top 20 nationally for pediatric nephrology by U.S. News & World Report, UCSF is where families can find the comprehensive expertise that rare and complex kidney diseases require.

One of Eight: The UCSF Pediatric Polycystic Kidney Disease Clinic

UCSF is one of only eight institutions in the country designated as a pediatric clinic for polycystic kidney disease (PKD) – a genetic condition where cysts grow in the kidneys and often lead to kidney failure. Because there is currently no FDA-approved treatment for children with PKD, expert symptom management and coordinated care are critical to preserving kidney function.

Led by Farzana Perwad, MD, chief of the Division of Pediatric Nephrology, along with Paul Brakeman, MD, PhD, and Erica Winnicki, MD, the clinic offers difficult-to-find dedicated PKD care by supplementing the nephrologists with genetic counselors, cardiologists, dietitians, and social workers in a single visit.

"Being one of eight pediatric PKD clinics in the country shows our leadership in the comprehensive management it demands,” says Perwad. “Coordinated care can transform the long-term outlook for a child’s kidney function, keeping away dialysis and transplant.”  

A Rare Network of Specialty Clinics

The PKD Center is part of a broader ecosystem of specialized programs — many of which are unique to the West Coast:

• Pediatric Stone: Kidney stones in children are rarely isolated events; they are often a signal for inherited metabolic disorders. This partnership with UCSF Urology focuses on finding the root cause and creating preventive care plans that protect long-term health.
• Pediatric Metabolic Bone Clinic: This clinic unites nephrology, endocrinology, orthopedics, and genetics to treat rare bone disorders like X-linked hypophosphatemia. UCSF is currently the only center in California participating in clinical research trials for this condition, providing access to promising therapies unavailable elsewhere.
• Pediatric Hypertension Program: Because uncontrolled high blood pressure can silently damage a child’s brain and eyes, early intervention is vital. This program specializes in diagnosing the underlying triggers of pediatric hypertension to develop targeted care strategies.
• Renal Precision Medicine Clinic: By supplementing traditional nephrology with advanced genetic counseling, families receive clear guidance on treatment options and inheritance patterns for genetic kidney diseases.

Built on a Foundation of Transplant Excellence

This specialized network is anchored by one of the nation's most established pediatric kidney transplant programs. With a one-year survival rate of over 94%, well above the national average, and around 20 transplants performed each year, the pediatric kidney transplant program serves as the primary center for Northern California, Nevada, and Hawaii.

These outcomes require comprehensive support from the Division’s Mental Health and Wellbeing Program. The team has embedded mental health specialists directly into transplant and dialysis teams, recognizing emotional resilience as critical to long-term health. Research shows that mental health support directly impacts how long transplanted organs survive, making this wrap-around care a clinical necessity.

Bringing Expertise Where Families Need It

While complex diagnoses are managed at hubs in San Francisco and Oakland, the UCSF Division of Pediatric Nephrology extends its reach through seven outpatient satellite clinics ranging from Santa Rosa and Stockton to Walnut Creek and Monterey. This network throughout the Bay Area ensures that routine care remains close to home, while specialized expertise is always available when a child's condition requires a deeper level of coordination.

"With complex kidney diseases, uncertainty on the cause and the path to getting better is a heavy burden on families,” Perwad notes. “Our team has experts in diagnosing rare kidney diseases in children and showing families the way to a healthy future. We want to replace months of fragmented questions with a single, clear path forward.”

A child’s healthy future shouldn't depend on how well their parents can navigate different specialists. From the first diagnosis in our specialized hubs to routine check-ups close to home, the UCSF Department of Pediatrics is here to help families through kidney disease.

Learn more about how the UCSF Division of Pediatric Nephrology advances treatments and care for pediatric kidney disease.