Peritoneal dialysis in children: Challenges for the new millennium

Advances in technology and experience accumulated over the past 2 decades h ave resulted in the ability to successfully provide chronic peritoneal dial ysis (PD) to children of all ages and sizes. However, many important clinic al issues remain, including uncertainty regarding the "optimal" dialysis do se for children, the treatment of growth retardation associated with renal insufficiency, prevention of peritonitis, and the challenge of caring for n ewborn infants with end-stage renal disease (ESRD). This article summarizes current knowledge in each of these 4 areas, highlighting not only the adva nces of the past quarter-century, but also the questions that persist as we initiate the new millennium. The outcome of children receiving PD will be markedly improved only when ongoing acid future research efforts reveal the optimal solutions to these important issues. (C) 2000 by the National Kidn ey Foundation, inc.