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Renal failure in children

Renal insufficiency may evolve over several years following an initial insult. Current models are inadequate, however, for predicting the rate of this progression, especially if they employ creatinine-based methods of measuring the glomerular filtration rate. Recombinant human erythropoietin has proven to be of great benefit in the treatment of renal anemia and may reduce pretransplant sensitization. Recombinant human growth hormone therapy can accelerate the growth of children with renal insufficiency, but the long-term effects of this therapy are still unclear. Cardiovascular disease is a major source of morbidity in adult survivors of renal transplantation. The complex lipid disorders of renal disease and corticosteroid therapy probably play a role in the development of coronary disease.