The management of end-stage renal disease in infants with imperforate anus

Atul K. Sharma, Clifford Kashtan, Thomas E Nevins

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Genitourinary malformations are frequently associated with imperforate anus, and death from renal failure is reported in up to 6% of children with supralevator imperforate anus. In recent years, advances in renal transplantation and the management of end-stage renal disease (ESRD) have extended these therapies to infants in the first 2 years of life. In infants with imperforate anus and ESRD, it is unclear if the additional burdens of the anorectal malformation and its staged repair contraindicate dialysis and transplantation. This report describes our experience with three such infants and outlines an approach to their care, addressing the following key issues: the initial surgical management of the imperforate anus, the careful search for associated urinary tract and other malformations, the ESRD management, and the appropriate timing of the staged bowel reconstruction and renal transplantation. These cases confirm that such children may be successfully managed by dialysis and renal transplantation co-ordinated with bowel reconstruction; however, there remain the longterm risks of immunosuppression, bladder and bowel dysfunction, and associated congenital anomalies.

Original languageEnglish (US)
Pages (from-to)721-724
Number of pages4
JournalPediatric Nephrology
Volume7
Issue number6
DOIs
StatePublished - Dec 1 1993

Keywords

  • End-stage renal disease
  • Imperforate anus
  • Kidney transplant
  • VATER

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