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.
KeywordsHemolytic Uremic Syndrome Secondary Hyperparathyroidism Chronic Renal Insufficiency Membranoproliferative Glomerulonephritis Reflux Nephropathy
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