Flynn J T, Warady B A
Division of Pediatric Nephrology, Department of Pediatrics and Communicable Diseases, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI, USA.
Adv Ren Replace Ther. 2000 Oct;7(4):347-54. doi: 10.1053/jarr.2000.16271.
Advances in technology and experience accumulated over the past 2 decades have resulted in the ability to successfully provide chronic peritoneal dialysis (PD) to children of all ages and sizes. However, many important clinical issues remain, including uncertainty regarding the "optimal" dialysis dose for children, the treatment of growth retardation associated with renal insufficiency, prevention of peritonitis, and the challenge of caring for newborn infants with end-stage renal disease (ESRD). This article summarizes current knowledge in each of these 4 areas, highlighting not only the advances of the past quarter-century, but also the questions that persist as we initiate the new millennium. The outcome of children receiving PD will be markedly improved only when ongoing and future research efforts reveal the optimal solutions to these important issues.
过去20年里技术的进步以及积累的经验,使我们有能力成功地为所有年龄和体型的儿童提供长期腹膜透析(PD)。然而,许多重要的临床问题依然存在,包括儿童“最佳”透析剂量的不确定性、与肾功能不全相关的生长发育迟缓的治疗、腹膜炎的预防以及照顾终末期肾病(ESRD)新生儿的挑战。本文总结了这四个领域的现有知识,不仅强调了过去25年取得的进展,也突出了在我们迈入新千年之际仍然存在的问题。只有当正在进行的和未来的研究工作找到这些重要问题的最佳解决方案时,接受PD治疗的儿童的预后才会得到显著改善。