There are few data describing the current practices of treatment selection
for children with endstage renal disease (ESRD). In an effort to establish
a consensus among Spanish pediatric nephrologists for inclusion and exclusi
on criteria for renal replacement therapy in children with ESRD, in 1995 we
surveyed members of the Spanish Pediatric Nephrology Association. Although
only 43% of members responded, pediatric nephrologists and bioethicists st
udied the results and compiled a list of ten guidelines for treatment of ch
ildren with ESRD. The proposed guidelines are meant to be a starting point
for further discussion. An emphasis on flexibility, individual case assessm
ent, and consideration of the best interests of the patient must remain cen
tral to any treatment plan. Decision making should ideally be shared by par
ents, professionals, the child, when appropriate, and ethics committees, as
necessary.