title: Adolescents and Young Adults with Chronic or End-Stage Kidney Disease.
abstract: BACKGROUND
  Adolescents and young adults face unique and complex physical, psychological, and family challenges. Despite improvements in care for chronic kidney disease (CKD) and end-stage kidney disease (ESKD), long-term mortality for children, adolescents, and young adults with CKD remains substantially higher than their healthy counterparts.
  
  
  CONCLUSIONS
  In this article, we discuss the complex challenges that adolescent and young adult CKD/ESKD patients face. Adolescents have different CKD etiologies and progress along a course dissimilar to the adult population, but have similar multifarious comorbidities. In the setting of puberty and learning to become self-sufficient, adolescence is a critical time for growth and psychosocial development. Physiological complications of CKD underlie many of the long-term outcomes. CKD-mineral and bone disorder and anemia are particularly challenging given that they are exacerbated by the rapid growth of adolescents. Endocrine imbalances and malnutrition can delay and limit growth. All of these factors, together with family dynamics and socioeconomic status, contribute to the poor long-term outcomes and decreased quality of life (QoL) for these patients and their families.
  
  
  CONCLUSIONS
  Care for the adolescent CKD/ESKD population is uniquely challenging, but research has identified ways in which we can continue to improve long-term outcomes and QoL for adolescents with CKD/ESKD.
authors.affiliation: University of North Carolina Kidney Center at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Maria E
authors.initials: ME
authors.lastname: Ferris
authors.forename: J Alexander
authors.initials: JA
authors.lastname: Miles
authors.forename: Meredith L
authors.initials: ML
authors.lastname: Seamon
mesh_terms: D000293:Adolescent; D000740:Anemia / Q000453:epidemiology* / Q000401:mortality / Q000523:psychology / Q000628:therapy; D001848:Bone Diseases, Developmental / Q000453:epidemiology* / Q000401:mortality / Q000523:psychology / Q000628:therapy; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality / Q000523:psychology / Q000628:therapy; D002648:Child; D015897:Comorbidity; D018450:Disease Progression; D004700:Endocrine System Diseases / Q000453:epidemiology* / Q000401:mortality / Q000523:psychology / Q000628:therapy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000401:mortality / Q000523:psychology / Q000628:therapy; D011788:Quality of Life / Q000523:psychology; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000401:mortality / Q000523:psychology / Q000628:therapy; D016019:Survival Analysis; D055815:Young Adult