The management of dialysis and transplantation in children.

Children with severe renal failure face numerous problems which are unique to their age group. The physiological and psychosocial changes which characterize growth and development must be integrated into the medical care of children requiring dialysis and renal transplantation. Congenital abnormalities are of greater importance in the young age group and glomerulonephritis less frequent as a cause of terminal renal failure. The problems of children during chronic hemodialysis often include retarded growth, sexual maturation and emotional development. Modifications in medications, equipment and technique are required for infants undergoing dialysis or transplantation. Growth following renal transplantation has been variably and related to renal function, age at transplantation, steroid therapy, and serum somatomedin activity. Rehabilitation has been achieved with both modes of therapy but is more likely following successful renal transplantation.