SE Ledermann

Abstract

Although the number of infants needing end stage renal failure (ESRF) management is small their care continues to present many ethical and practical challenges. The mortality in children starting dialysis age less than 1 year is higher compared to older children, with co-morbid non-renal disease a highly significant risk factor. Families must be carefully counselled as to the possible management options. Peritoneal dialysis is the treatment of choice if the infant is to be actively managed. Most infants will need enteral feeding and frequent adjustment of dialysis prescription, medications and feed recipe are necessary. Haemodialysis can be undertaken but problems with access are very common. The prognosis for survival, linear growth and development in otherwise normal infants is encouraging. Infant dialysis can now be performed in most infants with ESRF with the aim of facilitating early renal transplantation.