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5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat
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5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat

Published on: July 3, 2013

Management of the neonate with chronic renal failure

Lesley Rees1

  • 1Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, UK. Reesl@gosh.nhs.uk

Seminars in Fetal & Neonatal Medicine
|November 28, 2007
PubMed

Insights

Infant chronic dialysis is rare, mainly for urinary tract issues, with improving survival rates despite challenges. Long-term outcomes are good for healthy infants needing dialysis.

Area of Science:

  • Pediatric Nephrology
  • Neonatal Urology

Background:

  • Chronic dialysis in infants is uncommon but presents unique management challenges.
  • The majority of infants requiring dialysis have structural urinary tract abnormalities.
  • Over 50% of these cases are diagnosed before birth (antenatally).

Observation:

  • Infant dialysis patient numbers have remained stable over the past decade.
  • Mortality rates, while high, show a trend of improvement.
  • Comorbidities significantly increase mortality risk in this population.

Findings:

  • Dialysis management involves ethical considerations and frequent complications.
  • Most infants on chronic dialysis require enteral feeding.
  • Long-term prognosis for infants without comorbidities is comparable to older children.

Implications:

  • Care requires significant family and medical team commitment.
  • Improved management strategies may further reduce infant mortality.
  • Understanding long-term outcomes is crucial for patient and family support.

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