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Renal replacement therapies in neonates: Issues and ethics.

Rees, L; (2017) Renal replacement therapies in neonates: Issues and ethics. Seminars in Fetal and Neonatal Medicine , 22 (2) pp. 104-108. 10.1016/j.siny.2016.11.001. Green open access

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Abstract

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.

Type: Article
Title: Renal replacement therapies in neonates: Issues and ethics.
Location: Netherlands
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.siny.2016.11.001
Publisher version: http://dx.doi.org/10.1016/j.siny.2016.11.001
Language: English
Additional information: © 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.
Keywords: Chronic kidney disease, Dialysis, Ethics, Kidney, Neonate, Renal replacement therapy, Survival
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Biology and Cancer Dept
URI: https://discovery.ucl.ac.uk/id/eprint/1529100
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