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The Decision to Initiate Dialysis in Children and Adolescents

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Pediatric Dialysis

Abstract

There is limited evidence on the optimal timing of dialysis initiation in children. An estimate of the glomerular filtration rate (GFR) provides useful information in guiding this decision, but should not be utilized in isolation, especially since estimates of GFR are less precise at low levels of GFR. Available evidence suggests that the decision to initiate dialysis should be largely based on the presence of specific indications, including uremic symptoms, malnutrition and refractory laboratory abnormalities, and psychosocial considerations. Appropriate preparation of the patient and family for dialysis is critical to optimize patient outcomes.

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Authors and Affiliations

  1. Pediatric Nephrology and Hypertension, Le Bonheur Children’s Hospital, University of Tennessee Health Science Center, Memphis, TN, USA

    Rima S. Zahr

  2. Emory University and Children’s Healthcare of Atlanta, Division of Pediatric Nephrology, Atlanta, GA, USA

    Larry A. Greenbaum

  3. Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Heidelberg, Germany

    Franz Schaefer

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  1. Rima S. Zahr
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  2. Larry A. Greenbaum
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  3. Franz Schaefer
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Correspondence to Rima S. Zahr .

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Editors and Affiliations

  1. Department of Pediatrics, University of Missouri-Kansas City, School of Medicine, Division of Pediatric Nephrology, Children’s Mercy Kansas City, Kansas City, MO, USA

    Bradley A. Warady

  2. Stanford University School of Medicine, Division of Pediatric Nephrology, Department of Pediatrics, Palo Alto, CA, USA

    Steven R. Alexander

  3. Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany

    Franz Schaefer

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Zahr, R.S., Greenbaum, L.A., Schaefer, F. (2021). The Decision to Initiate Dialysis in Children and Adolescents. In: Warady, B.A., Alexander, S.R., Schaefer, F. (eds) Pediatric Dialysis. Springer, Cham. https://doi.org/10.1007/978-3-030-66861-7_9

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