Treatment of Chronic Renal Failure in Neonates, Infants and Toddlers

Overview

For many paediatric nephrologists, the management of infant with end stage renal disease (ESRD) continuesto present not only complicated technical aspects, but very often also an ethical dilemma. When severe neurologicalor visceral disorders are associated with ESRD, the question of withholding or withdrawing renal replacementtherapy (RRT) may be raised early after the delivery. Then, each case has to be considered individually. Optionsfor treatment are palliative, supportive care, or active dialysis and intensive policy of feeding to ensure maximumgrowth to enable early transplantation. Overnight cycling peritoneal dialysis is the preferred option in younginfants and toddlers. The management can be successful only, if there is full cooperation between the experiencedand competent team of paediatric nephrologists and other experts and compliance of the patient’s family.

Key words:
end stage renal failure, infants, toddlers, renal replacement therapy, peritoneal dialysis