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Long-Term Outcome of Chronic Dialysis in Children

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Pediatric Dialysis

Abstract

Kidney transplantation, and preferably preemptive transplantation, is widely accepted as the optimal mode of renal replacement therapy (RRT) in all children with end-stage kidney disease (ESKD). For this reason, data on the long-term outcome of dialysis in children are scarce. Yet, as most patients with ESKD have to undergo chronic dialysis while waiting for kidney transplantation, and some patients require dialysis for a long time, it is of imminent importance to evaluate the impact of long-term dialysis on the physical and psychosocial condition and development of children with ESKD.

This chapter reviews the potential hazards of long-term dialysis in children based on pathophysiology, adult data and the scarce pediatric epidemiological data that exist on the topic. While mortality in patients with pediatric-onset ESKD during the course of peritoneal dialysis (PD) and hemodialysis (HD) has decreased over the recent decades, mortality risk remains extremely high as compared to the general population. The morbidity associated with long-term dialysis is also examined in this chapter, focusing on cardiovascular disease, chronic kidney disease-mineral bone disorder, psychosocial development, and cognitive functioning. We also pay special attention to one of the most life-threatening late technical complications of PD: encapsulating peritoneal sclerosis (EPS).

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Honda, M., Terano, C., Inoguchi, T., Kikunaga, K., Harada, R., Groothoff, J.W. (2021). Long-Term Outcome of Chronic Dialysis in Children. In: Warady, B.A., Alexander, S.R., Schaefer, F. (eds) Pediatric Dialysis. Springer, Cham. https://doi.org/10.1007/978-3-030-66861-7_39

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