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[Chronic renal insufficiency in children]
1Service de néphrologie Hôpital Robert-Debré 75019 Paris. chantal.loirat@rdb.ap-hop-paris.fr
Insights
Chronic renal insufficiency (CRI) in children presents with feeding issues and poor growth. Treatments like growth hormone, dialysis, and transplantation can significantly improve outcomes and quality of life.
Area of Science:
- Pediatric Nephrology
- Growth and Development Disorders
Context:
- Chronic renal insufficiency (CRI) requires early diagnosis in children presenting with feeding difficulties, thirst, and poor weight/height gain.
- Recognizing CRI symptoms is crucial for timely intervention in pediatric patients.
Purpose:
- To outline the diagnostic considerations for chronic renal insufficiency in children.
- To detail the complications and management strategies for pediatric CRI.
Summary:
- CRI complications include electrolyte imbalances, nutritional deficits, osteodystrophy, growth retardation, and psychosocial challenges.
- Human recombinant growth hormone can significantly enhance growth in affected children.
- End-stage renal failure management involves hemodialysis or peritoneal dialysis (especially for <2 years), with renal transplantation offering the best long-term prognosis for a near-normal life.
Impact:
- Early diagnosis and comprehensive management of pediatric CRI can mitigate severe complications.
- Growth hormone therapy and renal replacement therapies offer substantial improvements in growth and quality of life.
- Renal transplantation provides the optimal solution for end-stage renal failure, enabling children to lead fulfilling lives with daily medication adherence.
Abstract:
The diagnosis of chronic renal insufficiency (CRI) must be evoked in children with feeding difficulties, excessive thirst, insufficient weight and/or height gain. Complications of CRI in children are hydroelectrolytic desequilibrium (chronic dehydration, sodium depletion, acidosis), nutritional difficulties, osteodystrophy, growth retardation and psychologic and scolar difficulties. Human recombinant growth hormone treatment generally allows spectacular growth improvement. In children with end-stage renal failure, operation is performed by hemodialysis or, especially in children less than 2 years of age, peritoneal dialysis. Renal transplantation is the best treatment of end-stage renal failure in children, as it offers them a practically normal life, with the only obligation of absorbing medications every day.