Dialysis

Providing optimum care to the infant, child, and adolescent patient requiring acute or chronic dialysis therapy demands that attention be directed to a variety of clinical issues. Pediatric patients with acute kidney injury frequently have comorbid conditions, substantial fluid overload, and marked disease activity. Modality choice for renal replacement therapy (e.g., intermittent or continuous dialysis treatment) is determined by a variety of factors, including provider preference, available institutional resources, dialytic goals, and the specific advantages and disadvantages of each modality. In patients requiring chronic peritoneal or hemodialysis, therapeutic plans must be made by a multidisciplinary team of pediatric specialists and surgeons to address the clinical parameters of growth, anemia and osteodystrophy management, cardiovascular disease, nutritional adequacy, education, cognitive development, quality of life, preparation of transplantation, and transition into adult care. This paper will provide an overview of the optimum care for children requiring acute or chronic dialysis treatment.