Inside the Region’s Only Pediatric Nephrology Program: Saving Kidneys, Preserving Childhood

Ayden Payano is a typical 7-year-old boy in so many ways. He plays basketball and flag football for the Bethlehem Township Athletic Association and enjoys school.

But in another way, Ayden is quite different. He has Stage 3 chronic kidney disease and posterior urethral valves, which can lead to lifelong complications and kidney failure.

Ayden is treated by Tecile Andolino, MD, and the expert team at St. Luke's Children’s Hospital and St. Luke’s Pediatric Specialty Center by the region’s only pediatric nephrology program.

"Essentially, Ayden was born with a membrane that blocks urine in the urethra from being able to pass from the kidneys to the bladder,” is how Dr. Andolino described posterior urethral valves.

Because this valve blocks the flow of urine, the membrane acts like a trapdoor, and instead of allowing normal passage, can prevent urine from leaving the bladder. The urine backs up and it creates higher pressure in the bladder and kidneys, which can damage the filters in the kidneys. Kidneys have a set number of filters from birth.

St. Luke’s Pediatric Nephrology team monitors pressure in Ayden’s kidneys and the risk for kidney failure.

“Our job is to screen for issues that can arise, and then manage and decrease those complications to preserve as much kidney function as humanly possible,” Dr. Andolino said.

Ayden and his parents, Christopher and Courtney, are thrilled with the compassionate and expert care of Dr. Andolino and her St. Luke’s team.

“Dr. Andolino is awesome and has been phenomenal in managing and monitoring Ayden’s kidney function,” Christopher Payano said. “Kids with Ayden’s condition are typically low energy and growth is not on path, but he is the opposite.

“He loves to play sports,” Christopher continued. “Dr. Andolino is awesome for advice on sports and health care. I had a job offer in North Carolina, but I wouldn’t take it just to stay with Dr. Andolino. She is the most positive person. She integrates medicine with real life.”

Christopher says that Dr. Andolino acts like a big sister to Ayden, explaining his condition and treatment in ways he can understand. In fact, “she is inspiring him to become a doctor one day,” Christopher said. “It’s hard to put into words how she affects him. She remembers every detail from his last visit.”

Echoing the St. Luke’s Children’s Hospital mantra of “We help kids and parents feel better,” Christopher said the care of Dr. Andolino and the pediatric nephrology team has had a profound impact on his marriage and his family of three children.

“There is a lot of stress when you are dealing with a chronic condition for your child,” he said. “It stresses us out at times, but knowing we can reach Dr. Andolino whenever, we feel we’re at the front of the fight. I would never go anywhere else.”