End-stage kidney disease in infancy: an educational review.

Document Type

Article

Publication Date

2-1-2020

Identifier

DOI: 10.1007/s00467-018-4151-8; PMCID: PMC6529305

Abstract

An increasing number of infants with end-stage kidney disease (ESKD) are surviving and receiving renal replacement therapy (RRT). Unique clinical issues specific to this age group of patients influence their short- and long-term outcomes. This review summarizes current epidemiology, clinical characteristics, ethical dilemmas, management concerns, and outcomes of infants requiring chronic dialysis therapy. Optimal care during infancy requires a multidisciplinary team working closely with the patient's family. Nutritional management, infection prevention, and attention to cardiovascular status are important treatment targets. Although mortality rates remain higher among infants on dialysis compared to older pediatric dialysis patients, outcomes have improved over time. Most importantly, infants who subsequently receive a kidney transplant are now experiencing graft survival rates that are comparable to older pediatric patients.

Journal Title

Pediatric nephrology (Berlin, Germany)

Volume

35

Issue

2

First Page

229

Last Page

240

MeSH Keywords

Kidney Failure, Chronic; Infant; Infant, Newborn; Infant, Newborn, Diseases; Renal Replacement Therapy

Keywords

Chronic hemodialysis; Chronic peritoneal dialysis; Growth; Hemodialysis; Infants; Neonates; Nutrition; Pediatric ESKD; Peritoneal dialysis

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