Peritoneal dialysis in children: challenges for the new millennium

Advances in technology and experience accumulated over the past 2 decades have resulted in the ability to successfully provide chronic peritoneal dialysis (PD) to children of all ages and sizes. However, many important clinical issues remain, including uncertainty regarding the "optimal" dialysis dose for children, the treatment of growth retardation associated with renal insufficiency, prevention of peritonitis, and the challenge of caring for newborn infants with end-stage renal disease (ESRD). This article summarizes current knowledge in each of these 4 areas, highlighting not only the advances of the past quarter-century, but also the questions that persist as we initiate the new millennium. The outcome of children receiving PD will be markedly improved only when ongoing and future research efforts reveal the optimal solutions to these important issues.