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…
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…
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…
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,…
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…