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Renal Replacement Therapy in Children

  • Raymond Donckerwolcke
  • Marcel Broyer
  • Cyril Chantler
  • Gianfranco Rizzoni

Abstract

Successful management of acute renal failure (ARF) in children, particularly infants, requires knowledge of the functional characteristics of the kidney during development and understanding of the metabolic balance of the growing child. The newborn kidney is immature containing only 17% of its adult cellular complement; at 6 months postnatally cell division is complete and further growth is due to an increase in cell size. Nephron formation is complete before birth but superficial cortical nephrons are not functionally mature; at birth the more mature juxtamedullary nephrons contribute a greater proportion of total glomerular filtration than in the adult. There is a proportional increase in juxtamedullary blood flow but total renal blood flow is low because of the high renal vascular resistance. Glomerular filtration rate (GFR) at birth averages about 20 ml/min/1.73 m2 body surface area but the rapid postnatal increase in renal blood flow is associated with a rapid rise in GFR to 48 ml/min/1.73 m2 at one month and to 80 ml/min/1.73 m2 by 6 months of age (1).

Keywords

Peritoneal Dialysis Acute Renal Failure Chronic Renal Failure Renal Replacement Therapy Continuous Ambulatory Peritoneal Dialysis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Kluwer Academic Publishers 1996

Authors and Affiliations

  • Raymond Donckerwolcke
    • 1
  • Marcel Broyer
    • 2
  • Cyril Chantler
    • 3
  • Gianfranco Rizzoni
    • 4
  1. 1.Department of NephrologyAlberta Children’s HospitalCalgaryCanada
  2. 2.Department of Pediatric NephrologyHospital for Sick ChildrenParisFrance
  3. 3.Evelina Children’s DepartmentGuy’s and St. Thomas’ HospitalLoncionEngland
  4. 4.Division of Nephrology and Dialysis Department of Pediatric Research and TeachingOspedale Bambino JesuRomeItaly

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