TY - JOUR VL - 22 SP - 104 IS - 2 N1 - © 2017. This manuscript version is published under a Creative Commons Attribution Non-commercial Non-derivative 4.0 International licence (CC BY-NC-ND 4.0). This licence allows you to share, copy, distribute and transmit the work for personal and non-commercial use providing author and publisher attribution is clearly stated. Further details about CC BY licences are available at http://creativecommons.org/licenses/by/4.0. Access may be initially restricted by the publisher. UR - http://dx.doi.org/10.1016/j.siny.2016.11.001 SN - 1878-0946 A1 - Rees, L JF - Seminars in Fetal and Neonatal Medicine Y1 - 2017/04// AV - public EP - 108 TI - Renal replacement therapies in neonates: Issues and ethics. N2 - Chronic irreversible kidney disease requiring dialysis is rare in the neonate. Many such neonates are diagnosed following antenatal ultrasound with congenital abnormalities of the kidneys and urinary tract. There is an increased incidence of prematurity and infants that are small for gestational age. Given the natural improvement in renal function that occurs in the neonatal period, some with extremely poor renal function may, with careful management of fluid and electrolytes, be kept off dialysis until the creatinine reaches a nadir when a definitive plan can be made. There is a very high incidence of comorbidity and this affects survival, which for those on dialysis is about 80% at five years. The multiple and complex ethical issues surrounding the management of these very young children are discussed. ID - discovery1529100 KW - Chronic kidney disease KW - Dialysis KW - Ethics KW - Kidney KW - Neonate KW - Renal replacement therapy KW - Survival ER -