[Inpatient, day clinic and ambulatory care of children and adolescents with chronic kidney disease].

Based on personal experience in caring for about 2,500 children with various kidney disorders, the role of individual factors such as age, diagnosis, and origin of patients for the type of medical care is discussed. Most patients can be cared for in an outpatient or day-clinic setting. Major interventions such as renal biopsy requiring hospital admission are exceptions. For a successful therapy a constant flow of information between medical practitioners or non specialised hospital services and the pediatric nephrology centre is needed. Daytime care in a clinical setting today is feasible in a number of situations, e.g. for performing renal function tests and for introducing parents into certain diagnostic or therapeutic procedures such as measurement of blood pressure, manual bladder expression and dietary manipulations. Training for home dialysis as well as centre dialysis are preferably performed under outpatient conditions. The recent introduction of continuous ambulatory peritoneal dialysis for outpatients has allowed to reduce the number of patients requiring hospital dialysis which is more expensive.