Ann Arbor: The Kidney Chapter

"Whatcha Talkin' 'Bout Willis"

Today we took Olivia to Ann Arbor today for a follow up with the Urology/Renal Clinic. As always the appointments never turn out quite the way we expected beforehand. We saw a very nice Nurse Practitioner, who took a lot of time asking about Olivia's History and previous procedures. Overall she was happy with Olivia's bloodwork, except for her Bicarb (think Baking Soda) level, which was low -- again. It is very common for children with Alagille Syndrome to have slightly Acidic blood levels due reduced kidney function. It was decided to start suplementing BiCarbonate to aleviate this acidosis by raising her Bicarb levels. 

The other semi-surprise today was that Olivia's Abdominal Ultrasounds (3 in total) taken over the last 2 months, don't all agree on the kidney findings. All the scans showed 'small' kidneys, but one -- the most recent one -- did not mention anything about a multi-cystic right kidney, while both the initial exams did make note of this finding. The possible problem here is that the Ultrasounds were not "Kidney Specific" but were more liver focused. A Kidney Specific Ultrasound has been set up for August to fully evaluate these discrepancies.

What does this mean? 

Honestly we aren't sure, what we did learn from this visit :

• Currently Olivia's Kidney function is good.
• There have been no changes since her original diagnosis
• "Small" kidneys aren't uncommon for babies Olivia's Size/Age
• It will be important to closely follow her kidney's growth/development over the next years
• It will be a while (2+ years) before a full determination of the full impact of her kidney dysplasia