From the day he was born, Dinero Motton relied on a precise balance of minerals, vitamins and fluids.
The main goal of his family and doctors was to optimize his nutrition while minimizing the strain on his kidneys, which are caused by the organs' inability to properly filter waste products.
Dinero was born with chronic kidney disease and was frequently hospitalized for doctors to check up and adjust his medication. Pediatric Nephrology Team, University of Michigan Health Center, C.S. Mott Children's Hospital.
Doctors developed a customized regimen to address mineral deficiencies, maintain nutritional health and avoid the dialysis that his mother, Francine Motton, was on.
“Francine basically became the chemist at home, mixing formula, measuring electrolytes and monitoring intake down to the milliliter,” Francine said. Michelle MillsThe CPNP is a pediatric nurse practitioner at Mott who has cared for Dinello since he was born.
“She did whatever it took to avoid hospitalization.”
When Motton was four months pregnant, she learned her baby had a bladder obstruction and enlarged bladder. As the condition progressed, she was told the baby was at high risk for kidney failure after birth, and was referred to the University of Michigan Health Center in 2021.
“When you get the news, it's hard to put into words what it feels like,” Motton said. “You just think: 'Why my child?'”
Complex Nutritional Needs Before Kidney Transplant
Dinero suffered from numerous complications associated with chronic kidney disease, including bone disease, excessive urination and unstable levels of iron, potassium, sodium and magnesium.
As a result of these imbalances, he requires a lot of fluid intake, preventing his normal development to begin eating solid foods.
“It's important to keep feeding under control and understand that certain things can come later,” Motton says. “Having a child with a chronic illness affects every aspect of your life and your mindset.”
Dinero's formula was changed multiple times to accommodate his special dietary needs, and certain changes helped him start gaining weight, something he'd struggled with since early childhood.
He finally met the body mass index requirement to be considered eligible for a transplant: in October 2023, he was officially placed on the waiting list.
But in November, a routine test revealed a deterioration in his kidney function: Dinero's kidneys were failing, at stage 5. He was sent to the emergency room to begin hemodialysis, a grueling treatment that cleanses the blood.
“Now that our son was on the transplant list, we knew we had to do everything we could to avoid any invasive procedures,” says Katie Byrne, a pediatric nephrology dietitian at Mott. “If he got an infection, we would have to wait even longer for a transplant.”
A recommendation was made to adjust Dinero's compounded medication regimen, a final attempt to delay dialysis.
“With just a few adjustments to his protein intake, he was able to return home to his family without dialysis,” Byrne said.
“Because of the trust we had built with Francine, we knew she would stick with this new feeding plan.”
Life-changing surgery
Shortly after this change in prescription, Dinero underwent a successful donor kidney transplant, which took place in December 2023, just before his second birthday.
He now has a teenager-sized kidney transplant in addition to his remaining original kidney. Since the surgery, Dinero has been going to hospital every week and has responded positively to his new organ.
“To see his amazing smile or feel his strong hugs, you would never imagine he had been through so much,” Mills said.
“His success story is truly a testament to his mother's strength. She always advocated for Dinero and did so with grace and courage.”
The team continues to monitor for signs of organ rejection, but the goal is for the kidney to last at least 15 years before he needs another transplant. Until then, Dinero is enjoying a happy childhood filled with coco melons, toy cars, and lots of applesauce.
“Watching my son battle this disease has taught me so much as a parent and caregiver,” Motton said.
“We are so grateful to the selfless people at Mott who are working to ensure he has a normal, healthy childhood.”
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