Psychosocial issues

In common with many chronic disease populations, children with chronic kidney disease experience high rates of psychosocial problems. Non-adherence with prescribed therapy is a major issue, particularly during the teenage years, and is associated with reduced transplant survival and other adverse outcomes. Many children have multiple co-morbidities and complex ethical issues may arise relating to the commencement of invasive life-prolonging interventions, including dialysis and transplantation. Where a decision is made to discontinue life-sustaining therapy, it is essential that appropriate palliative care is provided.