How to grow up with chronic kidney disease?

Abstract

The aim of this paper was to provide information on the best practice to allow children with chronic kidney disease (CKD) to attain normal adult physical and psychological development as well as social rehabilitation. Growth and development of children with CKD is associated with many problems that arise from the primary disease, the stage of CKD and complications of the disease and therapy. Only comprehensive treatment, which includes correction of metabolic disorders and anemia, normalization of growth and blood pressure, management of mineral and bone disease, psychosocial rehabilitation and renal replacement therapy by dialysis or renal transplantation in end-stage renal disease, can allow these patients to grow up. A multidisciplinary care team, including pediatricians, psychologists, dieteticians and social workers, can help to address these important needs of both patients and their caregivers. Adolescents with CKD, and especially those with end-stage renal disease (ESRD), face many additional challenges concerning their physical, emotional, educational and social demands, and they also need to take responsibility for their own care in order to achieve a good outcome and longer survival. The well-organized process of transition from pediatric to adult care institutions is important to raise the level of self-confidence, self-control and treatment compliance in adolescent patients. Conclusion – Pediatric CKD has many long-term consequences, of which treatment is best carried out by a multidisciplinary team. Kidney transplantation is the best therapeutic option for children with ESRD. The transition of adolescents from a pediatric to an adult institution must be gradual, and well prepared.