What I did today... Dr Atif Awan Paediatric Nephrologist
'Each morning I start with a ward round, or a problem-solving visit to the haemodialysis unit at Temple Street Children's Hospital.
"My patients, who include everyone from newborn babies to teenagers up to the age of 16, range from those suffering from kidney ailments such as kidney infections, high blood pressure, congenital problems and complex kidney diseases, to patients who have had a transplant or are on dialysis.
"The results of all investigations are reviewed daily. Any changes in terms of their immuno-suppression therapy or other medications such as blood pressure medicines or dialysis regime are communicated to parents.
"On any given day I could also be called to the intensive care unit to consult or to dialyse a patient with acute kidney failure.
"Afterwards I go to my clinic, which is held in Temple Street. I hold up to four clinics a week there.
"I have planned admissions in the day ward for investigation. Then I will meet the patients' parents after investigation and discuss the child's treatment.
"This is a comprehensive and efficient way of answering parents' questions and booking any further investigations or appointments.
"On the kidney day ward I would see very different patients -- some are new, with acute conditions necessitating urgent review, and others are patients already under my care with an acute problem.
"Each week I have meetings with staff from a variety of disciplines: transplant, haemodialysis, specialist nephrology unit or the radiology department.
"At these meetings patients' investigations are discussed and further management decisions made.
"I perform biopsies where required, to help determine the cause of kidney impairment in a particular patient or to find out what might be causing problems for a particular transplant.
"During my working day I would receive calls from hospitals around the country seeking an opinion about a child who may require urgent transfer or a review in clinic/renal day ward. Every day is different here.
"The staff and colleagues in all departments, in particular the laboratory, the intensive care unit as well as in radiology and in the theatres, have a great team spirit and a proactive attitude. I am fortunate to work with a group of nursing professionals who are specifically trained to deal with all types of kidney diseases.
"The number of patients is small, compared to the size of our adult population with renal problems, but it is extremely complex and labour intensive."