Active treatment of children with end-stage renal failure.

Chronic renal failure affects 1.5 children per million of the population each year. Most of these children are suitable for renal replacement therapy with the primary aim being full rehabilitation by means of a successful renal transplant. Since May 1974 12 children under the age of 16 years have entered the Christchurch dialysis-transplant programme. Six children had reflux nephropathy. Medullary cystic disease caused renal failure at the same time in identical twin girls. Dialysis was tolerated as a necessary step to transplantation. Major problems associated with home haemodialysis were the needling of the arteriovenous and the disruption of family life. After a successful transplant the children had few limitations. Chronic renal failure and its treatment in childhood were associated with growth retardation, delayed puberty and uncertainty regarding the future. With support from the family and friends these children attempted to lead a normal life.