Renal diseases and transplantation in children.

The diseases that are most commonly responsible for renal damage and end-stage renal disease are unique in children. The devastating effect of chronic renal failure on the mental and physical development of children offers many challenging management problems. Although less than perfect, successful renal transplantation is considered the best available treatment option for children, with the alternative of dialysis often made difficult by access problems, growth retardation and renal osteodystrophy. Children comprise between 5 and 8% of our transplant programme, and we consider transplantation and dialysis to be complementary rather than competitive.