I provide highly specialized care to children and young adults with all types of kidney disease, with a specific focus on end-stage renal disease and kidney transplantation. I am frequently consulted by colleagues throughout the world to advise with difficult complications of solid organ transplantation. I run a half-day outpatient pediatric nephrology clinic per week, mostly devoted to kidney transplant patients, but I also see patients sent for consultation by other pediatricians as well as patients previously under my care. When in charge of the pediatric nephrology inpatient service, I provide care to children with kidney problems admitted under my charge, consultative service to the other pediatric patients for kidney-related problems, and to the outpatient chronic hemodialysis and peritoneal dialysis patients at Shands Hospital. I perform kidney biopsies and acute hemodialysis or peritoneal dialysis in patients needing these specialized procedures. I also perform plasmapheresis and cellular apheresis for children with renal or non-renal diseases at St. Louis Children’s Hospital. As part of clinical care quality assurance and continuous quality improvement, I review on a very regular basis the quality measures related to procedures (biopsy complication rates), chronic dialysis (vascular access rates, anemia management, bone mineral management, immunization rates) and transplantation (patient and organ graft survival, immunization rates). My research interests are focused on end stage renal disease. I investigate the epidemiology of over-immunosuppression complications in transplantation using large national database linkages. I investigate biomarkers of acute and chronic rejection in translational studies (NIH grant R01DK102981, PI: Dharnidharka). I am investigating the microbial genomic patterns in stored paraffin tissue blocks of post-transplant lymphoproliferative disorder (Children’s Discovery Institute grant MC-II-2014-394, PI: Dharnidharka) . I am part of a consortium performing a randomized trial to improve adherence in teenagers with a kidney transplant and in consortia that study acute kidney injury (NIH grant R01 DK092977, PI: Foster). I am a site investigator in several industry studies of chronic kidney disease medications in children.