Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Feb;35(2):229-240.
doi: 10.1007/s00467-018-4151-8. Epub 2018 Nov 21.

End-stage kidney disease in infancy: an educational review

Keia R Sanderson  1 , Bradley A Warady  2
Affiliations
Review

End-stage kidney disease in infancy: an educational review

Keia R Sanderson et al. Pediatr Nephrol. 2020 Feb.

Abstract

An increasing number of infants with end-stage kidney disease (ESKD) are surviving and receiving renal replacement therapy (RRT). Unique clinical issues specific to this age group of patients influence their short- and long-term outcomes. This review summarizes current epidemiology, clinical characteristics, ethical dilemmas, management concerns, and outcomes of infants requiring chronic dialysis therapy. Optimal care during infancy requires a multidisciplinary team working closely with the patient's family. Nutritional management, infection prevention, and attention to cardiovascular status are important treatment targets. Although mortality rates remain higher among infants on dialysis compared to older pediatric dialysis patients, outcomes have improved over time. Most importantly, infants who subsequently receive a kidney transplant are now experiencing graft survival rates that are comparable to older pediatric patients.

Keywords: Chronic hemodialysis; Chronic peritoneal dialysis; Growth; Hemodialysis; Infants; Neonates; Nutrition; Pediatric ESKD; Peritoneal dialysis.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest relevant to this article to disclose.

Figures

Figure 1:
Figure 1:
Survival of children <18 years during initial course of chronic dialysis by age from 0 to 60 months. Image courtesy of NAPRTCS, reproduced with permission.
See this image and copyright information in PMC

References

    1. Hodson EM, Najarian JS, Kjellstrand CM, Simmons RL, Mauer SM (1978) Renal transplantation in children ages 1 to 5 years. Pediatrics 61:458–464 - PubMed
    1. Morse T (1970) Synthetic arteriovenous shunts for hemodialysis in children. J Pediatr Surg 5:23–31 - PubMed
    1. Geary DF (1998) Attitudes of pediatric nephrologists to management of end-stage renal disease in infants. J Pediatr 133:154–156 - PubMed
    1. Lantos JD, Warady BA (2013) The evolving ethics of infant dialysis. Pediatr Nephrol 28:1943–1947 - PMC - PubMed
    1. 2017 Annual Data Report: atlas of pediatric end-stage renal disease in the United States. United States Renal Data System (USRDS). 2017. [cited 2018 January 3,2018]; Available from: https://www.usrds.org/2017/view/v2_07.aspx.

Publication types