First Kidney Transplantation in Child at National Children's Medical Center

Abstract

Chronic kidney disease, regardless of etiology, have common mechanisms of progression and require certain therapeutic efforts aimed at delaying the onset of the end stage of chronic kidney disease. Once the estimated glomerular filtration rate (GFR) has decreased to less than 30ml/min per 1.73m2 and the child has stage 4 CKD, it is time to begin preparing the child and family for renal replacement therapy. For most patients with end-stage chronic kidney disease, kidney transplantation is the best renal replacement therapy (RRT) option, providing the maximum length and quality of life compared to other treatment options. Chronic kidney disease (CKD) is persistent impairment of kidney function, lasting for 3 months or more, defined as structural and/or changes in the body with varying degrees of decreased clearance function. NKF KDOQI recommendations. National Kidney Foundation; 2002. KDOQI Clinical Practice Guidelines for Chronic Kidney Disease: Assessment, Classification, and Stratification. Since the first successful kidney transplant in 1954, kidney transplantation has become the best treatment for adult patients with kidney failure. However, early pediatric kidney transplantation complicated by technical and immunological problems, resulting in worse patient and graft survival in children than in adults. Over the past 15 years, a number of advances have significantly improved patient and graft survival in pediatric kidney transplants. Kidney transplantation (KT) is the preferred renal replacement therapy for children with end-stage kidney disease (CKD) because survival and patient quality of life are better in children who receive a transplant compared to those who remain on dialysis. In addition, young children (under six years of age) are more likely to have improved growth after transplantation compared with those undergoing chronic hemodialysis or peritoneal dialysis.