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Caring for the Teenager in an Adult Unit
Overview of Transition/Transfer to Adult Care Adolescence is known as a period of transition toward adulthood that is characterized by significant developmental changes in cognitive, emotional, and social domains. For adolescent/young adult dialysis patients, this process also involves the acquisition…
Infectious Complications in Children Undergoing Dialysis
Introduction Infectious complications are a major cause of morbidity and mortality in children on peritoneal dialysis (PD) and hemodialysis (HD). This chapter reviews the major infectious risks of each modality, proposed preventive strategies, treatment guidelines, and areas for further development.…
Prevention and Treatment of Cardiovascular Complications in Children Undergoing Dialysis
Cardiovascular Mortality in Children on Maintenance Dialysis Reports from international registries since 2000 have confirmed, that like in adults, cardiovascular disease (CVD) is the leading cause of death in children with end-stage renal disease (ESRD) and young adults with childhood…
Management of Anemia in Children Undergoing Dialysis
Introduction Anemia is common and associated with adverse outcomes in children with chronic kidney disease. The management of anemia was dramatically changed due to the development of erythropoiesis-stimulating agents (ESAs) and new understandings of iron metabolism. As the adverse effects…
Prevention and Treatment of Bone Disease in Pediatric Dialysis Patients
Childhood and adolescence are crucial times for developing a healthy skeletal system; alterations in bone modeling/remodeling in youth carry consequences that severely impact quality of life even into adulthood. In childhood, chronic kidney disease (CKD) causes disordered regulation of mineral…
Continuous Renal Replacement Therapy in Pediatric Patients
Introduction Continuous renal replacement therapy (CRRT) is the preferred modality for the optimal management of fluid and electrolytes as well as nutritional support for children developing acute kidney injury (AKI) in the pediatric intensive care unit (PICU). Recent awareness about…
Adequacy of Peritoneal Dialysis/Assessing Peritoneal Function in Pediatric Patients
End-stage kidney disease (ESKD) is a debilitating disease, and its consequences are particularly detrimental in children who face a lifelong treatment burden. In the absence of the availability of a preemptive kidney transplant, dialysis initiation in children is recommended at…
Growth in Children With End-Stage Kidney Disease
Introduction Growth is a complex biologic process dependent on adequate nutrition as well as the integrated homeostasis of metabolic and endocrine pathways. Growth failure has long been recognized as one of the most common and profound complications seen in children…
Neurocognitive Function in Pediatric Dialysis
Introduction Children with chronic kidney disease (CKD) present unique clinical challenges to practitioners when compared to adults in two very important aspects. First, they differ with respect to physical growth. Linear growth occurs through childhood and continues into puberty. Second,…