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Dialysis for end-stage renal disease
1Division of Nephrology, Children's Hospital and Regional Medical Center, University of Washington, Seattle 98105, USA.
Insights
Peritoneal dialysis and hemodialysis are key treatments for pediatric end-stage renal disease. Optimizing dialysis adequacy and peritoneal membrane function improves growth, nutrition, and reduces complications in children.
Area of Science:
- Pediatric Nephrology
- Renal Replacement Therapy
Background:
- Peritoneal dialysis is a primary treatment for pediatric end-stage renal disease.
- Hemodialysis is also utilized for a significant number of children.
- Reducing morbidity and mortality are key objectives in pediatric dialysis.
Purpose of the Study:
- To highlight the importance of dialysis adequacy and peritoneal membrane function in children.
- To discuss strategies for improving growth, nutrition, and overall well-being in pediatric dialysis patients.
- To address emerging concerns regarding cardiovascular disease in long-term pediatric survivors.
Main Methods:
- Review of current pediatric dialysis practices and therapeutic advancements.
- Analysis of factors influencing growth, nutrition, and quality of life.
- Consideration of long-term outcomes and challenges in surviving pediatric patients.
Main Results:
- Adequacy of dialysis and peritoneal membrane function are critical for optimal outcomes.
- Supplemental gastrostomy feeding has improved nutritional status.
- Therapies like growth hormone and erythropoietin enhance quality of life.
Conclusions:
- Maintaining dialysis adequacy and peritoneal membrane function is essential for pediatric patients.
- Nutritional support and advanced therapies improve patient well-being.
- Long-term survival necessitates addressing cardiovascular risks and other adult mortality factors.
Abstract:
Peritoneal dialysis is the major renal replacement therapy for children with end-stage renal disease, with hemodialysis used for a substantial number of pediatric patients. Reduction of morbidity and mortality is a major goal with the use of these modalities. Adequacy of dialysis and maintenance of peritoneal membrane function are important considerations for children on long term dialysis. Both adequacy and function are important to ensure optimal growth and nutrition and improve morbidity in this population. Use of supplemental gastrostomy tube feeds has improved calorie-protein malnutrition. Therapy advancements, such as growth hormone and erythropoietin, have improved the quality of life for dialysis patients. As the survival of the pediatric patient with end-stage renal disease improves, issues regarding cardiovascular disease and other factors that increase mortality in the adult population will need to be addressed.