2009 Volume 22 Issue 1 Pages 1-5
Recently, dramatic breakthroughs in the management of end stage renal disease in children have improved the prognoses. However, when introducing renal replacement therapy to patients in end stage renal disease with mental retardation or other anomalous conditions, we have to carefully evaluate their level of disability and consider family compliance.
We recently introduced hemodialysis in three adult patients in end stage renal disease with mental retardation. All cases have been received medical care in our department because of their families offer. We needed to change the treatments in line with families wishes and their mental growth during the therapeutic process. Improvements in their quality of life and clinical condition were observed after starting hemodialysis.
In the treatment of end stage renal disease, coordination with internists, urologists, nurses, and other medical staff is very important. Therefore, to develop a positive relationship between medical staff and family is also desirable.
It isn't easy to provide renal replacement therapy for the patients with mentalretardation. Besides, there are no quick and easy methods of rendering decisions on treatment. Factors such as the patient's clinical condition, prognosis and family compliance must be considered and communicated to family members to allow full discussion of treatment options. The decision to begin renal replacement therapy must involve patients and their families, and medical staff must also respect family decisions to alter therapy.
