End Stage Renal Disease in Children: What is the Future?
End stage renal disease (ESRD) is rare in children compared with adults. About seven children/million less than 16 years of age develop ESRD each year in developed countries; one/million are less than 5 years old. The prevalence of chronic renal insufficiency (CRI) in the child population is about 18/million children. Many children with CRI will not reach end stage until late childhood or early adult life but a major responsibility for the pediatric nephrologist is to ensure that their development including their growth, social skills, and education is not compromised by CRI. Particular attention is required in the case of infants with CRI, for poor growth in the first years can lead to permanent stunting. Early referral to specialized units is necessary so that adequate nutritional support , including the control of uraemia  and secondary hyperparathyroidism  is obtained. More research is likely to lead to even better rehabilitation of these infants though even now optimum management usually ensures normal growth rates.
KeywordsFiltration Urea Creatinine Corticosteroid Cyclosporine
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- 1.Task force, American Academy of Pediatrics (1986) Nutritional therapy in chronic renal insufficiency. Pediatr Nephrol (to be published)Google Scholar
- 4.McKeown T (1976) The role of medicine; dream, mirage or nemesis? Nuffield Provincial Hospital Trust, LondonGoogle Scholar
- 7.McLean RH, Winkelstein JA (1985) Genetically determined variation in the complement system; relationship to disease. J Pediatr 105:175–188Google Scholar
- 8.Demaine AG; Vaughan RV, Taube DH, Kerr LA, Welsh KI (1986) Immune genotyping in renal disease. Renal Association, London (abstract)Google Scholar
- 9.Gilli G, Berry AC, Chantier C (1986) Syndromes with a renal component. In: edited by Halliday MA, Barratt TM; Vernier & (eds) Pediatric nephrology Williams and Wilkins, Baltimore (to be published)Google Scholar
- 11.Allan LD, Crawford DC, Chita SK, Tynan MJ (1986) Prenatal screening for congenital heart disease. Br Med J (to be published)Google Scholar
- 12.Winberg J (1984) Reflux nephropathy or delay nephropathy. In: Brodehl J, Ehrich JHH (eds) Pediatric nephrology. Springer, Berlin Heidelberg New York, pp 333–336Google Scholar
- 14.Scott DJ, Blackford HN, Joyce MRL, Mundy AR, Kinder CH, Haycock G, Chantier C (1986) Renal function following surgical correction of vesicoureteric reflux in childhood. Br J Urol 58:115–124Google Scholar
- 17.Haycock GB, Cameron JS (1986) The nephrotics of Schonlein - Hanoch purpura. In: Glassock LJ (ed) Current therapy in nephrology, 2nd edn. Decker, Philadelphia (to be published)Google Scholar
- 20.Trompeter RS, Bewick M, Haycock GB, Chantier C (1983) Renal transplantation in very young children Lancet 1:673–675Google Scholar
- 21.Nevins JE (1986) Transplantation in infants less than one year of age. Pediatr Nephrol (to be published)Google Scholar
- 22.Haycock GB (1984) Intra-operative and immediate postoperative care in the management of the paediatric transplant recipient. In: Brodehl J, Ehrich JHH (eds) Pediatric nephrology. Springer, Berlin Heidelberg New York, pp 146–148Google Scholar
- 23.Bewick M, Snowden S, Taube D, Welsh K (1986) Successful renal transplantation of high risk patients Transplant Proc (in press)Google Scholar
- 25.Mundy AR, Nurse DE, Dick JA, Murray KHA (1986) Complex urinary diversion - is there such a thing as a hopeless case? Br J Urol (to be published)Google Scholar