THE CHANGING PATTERN OF CHILDRENS DIALYSIS AND TRANSPLANTATION OVER 20 YEARS

The changing treatment and outcome for children with chronic renal fai lure (CRF) requiring renal replacement therapy (RRT) was assessed in c hildren referred to the only paediatric unit in the North West Region of England between 1968 and 1988. There were 108 children. Referrals i n consecutive 5-year time periods increased from 9 to 41 over the 20 y ears with the overall incidence of new referrals less than 15 years ol d reaching 8.5 per million childhood population in 1983-87, whilst the proportion of children under 5-years increased from O% to 22%. The su rvival rate was better in those commencing RRT in the later years: 5-y ear survival 56% for the 1968-72 cohort vs 88% for 1978-82. The increa sing number of referrals particularily among young children, coupled w ith improved survival rates have considerable implications when determ ining the provision of care for children with ESRD.