title: Anorectal malformation and associated end-stage renal disease: management from newborn to adult life.
abstract: OBJECTIVE
  Renal failure remains one of the most significant causes of morbidity in patients with anorectal malformations (ARM). In the modern era, an increasing number of children born with ARM and genito-urinary (GU) anomalies reach adulthood and require continued multidisciplinary care for the rest of their life. The aim of this study is to present our institutional experience in the management of pediatric chronic renal failure related to severe GU anomalies and anorectal malformations.
  
  
  RESULTS
  Three hundred twenty-one patients with ARM have been followed at our institution since 1987. Six patients developed end-stage renal disease (ESRD) and received a kidney transplant at different ages. One patient is currently followed for mild, progressive chronic renal failure. These seven cases are reported along with a broad discussion concerning etiology of renal failure, neonatal surgical management, pediatric dialysis, urologic issues, and kidney transplantation.
  
  
  CONCLUSIONS
  Complex GU anomalies associated with ARM require a long-term approach by specialized pediatric and adult clinicians to optimize the care of this selected population of patients.
authors.affiliation: Division of Pediatric Surgery, St George's Hospital NHS Trust, London, United Kingdom. stefano.giuliani@nhs.net
authors.forename: Stefano
authors.initials: S
authors.lastname: Giuliani
authors.forename: Paola
authors.initials: P
authors.lastname: Midrio
authors.forename: Roger E
authors.initials: RE
authors.lastname: De Filippo
authors.forename: Enrico
authors.initials: E
authors.lastname: Vidal
authors.forename: Marco
authors.initials: M
authors.lastname: Castagnetti
authors.forename: Giovanni Franco
authors.initials: GF
authors.lastname: Zanon
authors.forename: Pier Giorgio
authors.initials: PG
authors.lastname: Gamba
mesh_terms: D000328:Adult; D000071056:Anorectal Malformations; D001006:Anus, Imperforate / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D055815:Young Adult