Medical and psychosocial rehabilitation of young adults receiving renal replacement therapy since childhood: A single-centre experience

Abstract

This study reviews medical and psychosocial rehabilitation of children and adolescents with end-stage renal disease (ESRD) and analyses data of young adults with ESRD from a single centre providing renal replacement therapy (RRT) for more than 20 years. Data from 30 patients, aged 25 ± 4 (18-34) years receiving renal replacement therapy (RRT) since childhood were analysed. Medical and psychosocial rehabilitation were assessed by a medical questionaire and by chart review. The sociological data were compared to an aged-matched control population (n = 26) with long-standing diabetes mellitus type I (DM) and to the available national demographic data. Seventeen patients were treated by dialysis (D) and 13 by transplantation (TPL). The duration of RRT was 13 (1-21) years. Growth failure was pronounced in most patients, and a significant number were suffering from hypertension, left ventricular hypertrophy, anaemia, osteodystrophy, hepatitis, and physical disabilities. Vocational training/school performance, and employment was not markedly different in patients with RRT and controls with DM. However, the type of employment was different with an overrepresentation of lower-income jobs in RRT patients. Most patients with RRT were unmarried and one-third was living with their parents. These data, largely reflecting early experience of a paediatric RRT programme, indicate that young adults receiving RRT from childhood have a multitude of medical and psychosocial problems, providing a continuing challenge for centres providing RRT.