Towards guidelines for dialysis in children with end-stage renal disease

Riaño, Isolina; S, Málaga; Callı́s, L; Loris, C; Martín-Govantes, Juan; Navarro, Mercedes; Vallo, Alfredo

doi:10.1007/s004679900169

Cited by 14 publications

(8 citation statements)

References 11 publications

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“…Renal transplantation is found to be a reasonable option in end-stage renal failure treatment for DS patients [34], and it seems to be the preferred treatment modality, although a few pediatric cases of DS on dialysis have been reported [35]. Nonetheless, the absence of other serious medical problems, level of psychomotor development and family support also must be taken into account in order to choose the best treatment option when the patient develops endstage renal disease [36].…”

Section: Discussionmentioning

confidence: 99%

Renal involvement in Down syndrome

S¹,

Pardo

Málaga

et al. 2005

Pediatr Nephrol

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Kidney disease has not been considered a frequent complication in Down syndrome (DS) patients; a variety of urological abnormalities and glomerulopathies have been reported in this population, and some DS patients develop chronic renal failure (CRF). The aim of this study was to improve the understanding of renal disease in patients with DS, focusing on the incidence and range of kidney and urological abnormalities in a population of DS patients. A cross-sectional study was carried out in DS patients referred from a pediatric genetics unit of a tertiary care center. Medical records were reviewed. A 24-h urine specimen and a blood sample were obtained. Fractional excretion of sodium and potassium, tubular reabsorption of phosphate, urinary excretion of calcium, magnesium, uric acid, creatinine clearance and proteinuria were determined. Ultrasound was performed to evaluate the kidneys and the urinary tract. Laboratory data were reviewed for any possible renal disorder. Sixty-nine patients, aged 12 months to 24 years, were recruited. Pathological findings included three cases of voiding disturbances and a case of hypertension in a 7-year old girl. Eight patients (11.6%) had hyperuricemia without gout. Eighteen patients (24.2%) had hyperuricosuria. Urinalysis revealed three cases of mild proteinuria and two patients with microscopic hematuria. Minor radiological abnormalities were found in five patients (7.3%). Three patients (4.5%) had CRF. Renal disease in patients with DS is not as rare as previously thought, although the majority of findings are of minor relevance. According to the variety of pathologies, and in order to detect early irreversible renal injury, it seems quite reasonable to perform regular monitoring of renal function in these patients.

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Section: Discussionmentioning

confidence: 99%

Renal involvement in Down syndrome

S¹,

Pardo

Málaga

et al. 2005

Pediatr Nephrol

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“…The resultant guidelines recommend that health professionals actively involve parents in the decision-making process and that they respect a parental right to agree or to refuse RRT (15). Additionally, the guidelines indicate 465 PDI jUly 2011 -VOl.…”

Section: Differences Over Timementioning

confidence: 99%

Attitudes of Caregivers to Management of End-Stage Renal Disease in Infants

et al. 2011

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“…Some medical teams consider that the initiation of RRT may not always be in the best interest of infants with ESKD [14], owing to the burdens of therapy on the family and uncertainties regarding satisfactory outcomes [13][14][15][16]. In addition, the Spanish guidelines for treatment of ESKD in children recommend that only children with reasonable quality-of-life expectations, favorable prospects for survival, and real possibilities for kidney transplant should be considered for RRT [35]. Furthermore, guidelines for ethical decision-making processes may differ between countries.…”

Section: Discussionmentioning

confidence: 99%