Encouraging survival of infants with terminal renal failure combining dialysis and succeeding early transplantation.
Dialysis in newborns and infants is a very challenging field in pediatric nephrology and still associated with high mortality. This article is designed for pediatricians who advise parents of newborns with renal failure. It aims to provide information about the difficulties during the period of dialysis and outcome after successful transplantation. We report upon five patients who proceeded to end-stage renal failure within the first year of life. All patients received peritoneal dialysis; however, two had to be switched to hemodialysis for several months. Four patients received percutaneous endoscopic gastric tubes (PEG) to enable high caloric diet. At the age of 1.5 to 5 years all children were successfully transplanted achieving good renal function. With regard to severe complications, hospitalisation time and somatic development all patients showed a substantial improvement after renal transplantation. Growth velocity increased to above SDS +2 after transplantation and all children reached the milestones of development in due time. In conclusion, after renal replacement therapy is initialised in infants with end-stage renal failure, sufficient nutrition to improve weight gain and to achieve the earliest possible transplantation is mandatory. Early transplantation results in a catch-up of developmental delay in short time.
Sauerstein
K
K
Department of Pediatrics, University of Erlangen-Nürnberg.
Zimmermann
B
B
Benz
K
K
Dittrich
K
K
Rascher
W
W
Dötsch
J
J
D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005183:Failure to Thrive; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007676:Kidney Failure, Chronic / Q000628:therapy*; D016030:Kidney Transplantation; D010530:Peritoneal Dialysis; D006435:Renal Dialysis; D013997:Time Factors; D016896:Treatment Outcome