Nephrol Dial Transplant (2002) 17: 1564-1567
© 2002 European Renal Association-European Dialysis and Transplant Association
Child-Adult Interface
Management of the infant with end-stage renal failure
Department of Nephrourology, Great Ormond Street Hospital for Children NHS Trust, London, UK
Keywords: dialysis; end-stage renal failure; infant; outcome
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Introduction
One of the greatest challenges for the paediatric nephrologist is the successful management of the infant with end-stage renal failure (ESRF). At no other time are there so many emotional and ethical dilemmas, both for the family and the medical team. The birth of such an infant may have been preceded by months of parental anxiety, as termination of pregnancy may have been discussed, or foetal interventions undergone. Parents are fearful for the outcome of their baby, which can only be successful if there is full commitment from themselves and a highly skilled and resourced medical team. It is at this time of vulnerability that families and the medical team must discuss together the multiple factors affecting the management and potential outcome for their child, before making the decision to embark on long-term renal replacement therapy.
The scope of the problem
Although the acceptance of infants onto ESRF programmes has become increasingly common over the
Diagnoses
Prognostic indicators
What are the treatment options?
Palliative and supportive care
Intensive management
Peritoneal dialysis
Haemodialysis
Clinical management
Dietary management
Renal transplantation
Growth
Long-term emotional and developmental outcome
Conclusions
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