Peritoneal dialysis is the major renal replacement therapy for children with end-stage renal disease, with hemodialysis used for a substantial number of pediatric patients. Reduction of morbidity and mortality is a major goal with the use of these modalities. Adequacy of dialysis and maintenance of peritoneal membrane function are important considerations for children on long term dialysis. Bot...

GUIDELINE RECOMMENDATIONS • We recommend that either synthetic or cellulosic membranes be used for symptomatic intra-dialytic hypotension as synthetic membranes offer no benefit over cellulosic membranes (1C). • We recommend that high-flux membranes be used to remove molecules such as beta-2 microglobulin because they have been shown to achieve lower serum levels (1A). • We suggest there are po...

p eritoneal dialysis has undergone considerable change since it was first used in managing end stage renal disease (ESRD) patients in the early 1960s. Its use then was predominantly as a holding procedure for hemodialysis, and as such, it was used in a very limited number of patients. With the introduction of continuous ambulatory peritoneal dialysis (CAPD) in 1976, the use ofPD has increased d...

A number of considerations suggest that trace element disturbances might occur in dialysed patients. These must at least in part be ascribed to the dialysis treatment itself during which these constituents may either be transferred to or removed from the patient. Tap water must be considered as the main source of dialysate trace metal contamination. These can adequately be removed during water ...

Truly adequate dialysis would restore patients to full health, with functional status and length of life indistinguishable from others of the same age, sex, and race without chronic kidney disease. We are far from achieving such outcomes, however, in part because of the dearth of available evidence on which areas of care should be emphasized to get the greatest clinical and psychosocial benefit...