Inherited dysfunction of amino and organic acid metabolism usually manifests in the early neonatal period by neurologic abnormalities such as irritability, somnolence, and, eventually, coma. In urea cycle defects or organic acidemias, these symptoms are mainly due to excessive hyperammonemia,…
Introduction Peritoneal dialysis (PD) has long been considered an effective treatment modality for neonates and infants with severe acute kidney injury (AKI) and is the dialysis modality of choice for patients in this age group with end-stage kidney disease (ESKD).…
Nutritional management is a key component of the care of children treated with peritoneal dialysis (PD). This includes regular assessment of nutritional status as well as development and implementation of a dietary prescription. Optimal nutritional management requires collaboration among the…
Peritoneal dialysis (PD) became a more available therapy for children in the 1960s, such that it was no longer considered “experimental” by the early 1970s. Further advances have been made in the size of catheters and tubing and the technology…
Introduction Extracorporeal blood purification techniques are associated with clotting of the extracorporeal circuit; therefore, with the exception of some coagulation disorders, anticoagulation is mandatory. In pediatric practice, the relative surface area of the extracorporeal circuit is increased in relation to…
The life span of a child on dialysis is 40 to 60 years less than that of the general population, but that of a pediatric transplant recipient is 20 to 30 years less than the general population. There is no…
Chronic Hemodialysis in Children Although renal transplantation is the optimal treatment for end-stage kidney disease in children and adolescents, many pediatric patients nonetheless must spend some time on chronic dialysis. Historically, a much larger proportion of children than adults undergo…
Vascular Access Hemodialysis requires a central venous catheter, and in infants, this poses technical challenges because of their smaller vessel size and the likelihood that they may require vascular access throughout their lifetime if end-stage renal disease is present. Dialysis…
Dialysis Access in the Pediatric ESRD Patient Vascular Access in Children Introduction Renal transplantation is the most common renal replacement modality for prevalent children with end-stage renal disease (ESRD). However, hemodialysis (HD) continues to be the most common initial treatment.…
More than 2 million poisonings were reported to the American Association of Poison Control Centers in 2021. Outcomes are generally favorable, and supportive measures alone are sufficient to manage the majority of poisonings. In selected situations, gastrointestinal decontamination, timely administration…