Children on Dialysis

As a result of improved neonatal, pediatric, and urologic care, the number of children surviving with end-stage renal disease is increasing. Each year one or two children per million population require renal-replacement therapy.1 Although successful rehabilitation of these children, in terms of reversal of uremia, growth, education, and psychosocial development, is best achieved by renal transplantation, shortages of donor organs and the limitations of current regimens of immunosuppressive therapy necessitate short-term or long-term dialysis therapy for many of them. Long-term hemodialysis results in reasonably good biochemical control of uremia. However, growth is generally poor; sexual development is delayed; and other . . .