[Psychosocial care in the overall therapeutic concept of the management of children with chronic kidney diseases].

In terms of physical health, degree of rehabilitation and the personal assessment of the affected patients, kidney transplantation represents the optimal therapy for children with chronic renal insufficiency. The best results are achieved by transferring organs from relatives. However, this can only be accomplished if medical treatment is accompanied and supported by continuous psychosocial care of the patient, the family and the treatment team. The problem of noncompliance requires special attention, since it may be the reason for rejection of transplants; it can, however, be recognized by preliminary preventive investigations and prevented by appropriate therapy. Our positive overall experience concerning parenthood following kidney transplants does not appear to justify dissuading such patients from having children if they so wish. However, we consider that especially young women who already have impaired function with a transplanted kidney should be advised of the risk of further deterioration during pregnancy, and that the possibility of reduced life expectancy should be discussed with these patients as a matter of urgency.