Management of the neonate with chronic renal failure.

The number of infants requiring chronic dialysis is small and has remained stable over the last decade. The majority have structural abnormalities of the urinary tract and over 50% are diagnosed antenatally. Mortality rate is high, particularly in infants with comorbidity, but has been improving. Management presents many challenges: as well as ethical issues, complications of dialysis are common and most infants need enteral feeding. Commitment from the family and medical team is crucial for success. However, the long-term outcome for otherwise healthy infants is comparable to that of older children.