Ethical issues and children with chronic kidney disease

Ethical decision making is as important as clinical management, especially as in developed countries we can now offer dialysis support to children of all ages with future kidney transplantation in mind. However, more children are being referred for treatment with major co-morbidities and the treatment, especially in infants, imposes a high burden of care and costs on the family. Withholding or withdrawing dialysis treatment may be appropriate options and this article illustrates some of the ethical dilemmas that may arise. Acting in the greater best interests of the child and consensus building are emphasised.