Selected Primary Care Issues and Comorbidities in Children Who Are on Maintenance Dialysis

Abstract

Ten-year survival of all children who initiate dialysis at any age now approaches 70%, and in the older child this number is closer to 80%. These children will live with chronic kidney disease and its myriad of associated comorbidities during and throughout their childhood. Their care is complex and requires both teamwork and careful attention paid to maintaining lines of communication among patient, family, and both the facility-based nephrology team and caregivers who are outside the hospital setting. Irrespective of their need for dialysis, children with ESRD deserve and require developmentally appropriate care and anticipatory guidance with respect to primary care issues of childhood. The child who is on dialysis often is cared for solely or in large part by a nephrology service, therefore this review discusses issues that are particularly important to pediatric nephrologists in relation to selected primary care issues and comorbidities for the child who is on dialysis, with an emphasis on medical and psychosocial issues, and with particular weight placed on issues that are pertinent to the adolescent dialysis patient.

Health-related quality of life in patients with pediatric onset of end-stage renal disease: state of the art and recommendations for clinical practice

“…As noted earlier, attention could also be paid to identifying neurocognitive or behavioral abnormalities that may have a significant negative impact on the likelihood of success in the classroom. A psychologist-directed assessment can be particularly helpful as a means of detecting specific learning difficulties and targeting particular educational strategies [85]. …”

Sexually transmitted infection screening and reproductive health counseling in adolescent renal transplant recipients: Perceptions and practice patterns. A study from the Midwest Pediatric Nephrology Consortium

“…Regardless of the method chosen, establishing a trusting relationship with the adolescent and ensuring confidentiality is paramount to effective counseling delivery. Pediatric nephrologists have a unique advantage in this regard, as many have acted in primary care provider capacities for adolescent transplant recipients since their initial contact with the healthcare system for nephrology care .…”

“…The perception and practice patterns of pediatric nephrologists regarding STI screening and reproductive health counseling are unknown. Pediatric nephrologists likely have the most frequent contact and serve as the “primary care provider” for children with ESKD and renal transplants and may be their only contact with the healthcare system . Therefore, we sought to understand the current practice patterns, perceived confidence level of providers, and barriers to routine implementation of STI screening and reproductive health counseling by pediatric nephrologists for their adolescent renal transplant recipients.…”

Luaran Pasien Anak dengan Gagal Ginjal Terminal

“…Hal itu berarti perlu kerja sama berbagai pihak seperti pasien, orangtua, pelayan kesehatan (dokter dan perawat), pihak rumah sakit, dan pemerintah. 5 Data…”