Towards guidelines for dialysis in children with end-stage renal disease

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.