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c + p r o c e s s + i s + t h e + s a m e + r e g a r d l e s s + o f + t h e + o r g a n + a f f e c t e d % 3 a + m i c r o t h r o m b i + i n h i b i t + n e c e s s a r y + b l o o d + f l o w + a n d + c a u s e + t i s s u e + d e a t h + o r + d a m a g e + d u r i n g + t h e + a c u t e + s t a g e + o f + h e m o l y t i c + u r e m i c + s y n d r o m e % 2 c + p a t i e n t s + m u s t + b e + c a r e f u l l y + m o n i t o r e d + f o r + t h e s e + e x t r a - r e n a l + c o m p l i c a t i o n s + i t + i s + v e r y + d i f f i c u l t + t o + p r e d i c t + t h e + s e v e r i t y + a n d + c o u r s e + o f + h u s + o n c e + i t + i n i t i a t e s % 0 a t h e + a c t i v e + s t a g e + o f + h e m o l y t i c + u r e m i c + s y n d r o m e + m a y + b e + d e f i n e d + a s + t h a t + p e r i o d + o f + t i m e + d u r i n g + w h i c h + t h e r e + i s + e v i d e n c e + o f + h e m o l y s i s + a n d + t h e + p l a t e l e t + c o u n t + i s + l e s s + t h a n + 1 0 0 % 2 c 0 0 0 + i n + h u s % 2 c + t h e + a c t i v e + s t a g e + u s u a l l y + l a s t s + a n + a v e r a g e + o f + s i x + d a y s + % 2 8 r a n g e % 2 c + 2 - 1 6 + d a y s % 2 9 + i t + i s + d u r i n g + t h e + a c t i v e + s t a g e + t h a t + t h e + c o m p l i c a t i o n s + o f + h u s + p e r + s e + u s u a l l y + o c c u r % 0 a w h a t + a r e + t h e + c o m p l i c a t i o n s + a n d + l o n g - t e r m + r i s k s + a s s o c i a t e d + w i t h + h e m o l y t i c + u r e m i c + s y n d r o m e % 3 f % 0 a s e v e r a l + s t u d i e s + h a v e + d e m o n s t r a t e d + t h a t + c h i l d r e n + w i t h + h u s + w h o + h a v e + a p p a r e n t l y + r e c o v e r e d + w i l l + d e v e l o p + h y p e r t e n s i o n % 2 c + u r i n a r y + a b n o r m a l i t i e s + a n d % 2 f o r + r e n a l + i n s u f f i c i e n c y + d u r i n g + l o n g - t e r m + f o l l o w - u p % 0 a e n d + s t a g e + r e n a l + d i s e a s e % 2 c + d i a l y s i s + a n d + k i d n e y + t r a n s p l a n t a t i o n % 0 a e n d + s t a g e + r e n a l + d i s e a s e % 0 a c h i l d r e n + a n d + a d o l e s c e n t s + w i t h + c h r o n i c + r e n a l + f a i l u r e + f a c e + a + n u m b e r + o f + c o m p l i c a t i o n s + f r o m + t h e + c o n d i t i o n % 2 c + i n c l u d i n g + a l t e r a t i o n s + i n + c a l c i u m + a n d + p h o s p h a t e + b a l a n c e + a n d + r e n a l + o s t e o d y s t r o p h y + % 2 8 s o f t e n i n g + o f + t h e + b o n e s % 2 c + w e a k + b o n e s + a n d + b o n e + p a i n % 2 9 % 2 c + a n e m i a + % 2 8 l o w + b l o o d + c e l l + c o u n t + t h a t + l e a d s + t o + a + l a c k + o f + e n e r g y % 2 9 % 2 c + g r o w t h + f a i l u r e + % 2 8 f i n a l + h e i g h t + a s + a n + a d u l t + s u b s t a n t i a l l y + b e l o w + n o r m a l % 2 9 % 2 c + h y p e r t e n s i o n + % 2 8 h i g h + b l o o d + p r e s s u r e % 2 9 % 2 c + a n d + o t h e r + c o m p l i c a t i o n s % 0 a r e n a l + o s t e o d y s t r o p h y + % 2 8 s o f t e n i n g + o f + t h e + b o n e s % 2 9 + i s + a n + i m p o r t a n t + c o m p l i c a t i o n + o f + c h r o n i c + r e n a l + f a i l u r e + b o n e + d i s e a s e + i s + n e a r l y + u n i v e r s a l + i n + p a t i e n t s + w i t h + c h r o n i c + r e n a l + f a i l u r e % 3 b + i n + s o m e + c h i l d r e n % 2 c + s y m p t o m s + a r e + m i n o r + t o + a b s e n t + w h i l e + o t h e r s + m a y + d e v e l o p + b o n e + p a i n % 2 c + s k e l e t a l + d e f o r m i t i e s + a n d + s l i p p e d + e p i p h y s e s + % 2 8 a b n o r m a l + s h a p e d + b o n e s + a n d + a b n o r m a l + h i p + b o n e s % 2 9 + a n d + h a v e + a + p r o p e n s i t y + f o r + f r a c t u r e s + w i t h + m i n o r + t r a u m a + t r e a t m e n t + o f + t h e + b o n e + d i s e a s e + a s s o c i a t e d + w i t h + c h r o n i c + r e n a l + f a i l u r e + i n c l u d e s + c o n t r o l + o f + s e r u m + p h o s p h o r u s + a n d + c a l c i u m + l e v e l s + w i t h + r e s t r i c t i o n + o f + p h o s p h o r u s + i n + t h e + d i e t % 2 c + s u p p l e m e n t a t i o n + o f + c a l c i u m % 2 c + t h e + n e e d + t o + t a k e + p h o s p h o r u s + b i n d e r s % 2 c + a n d + t h e + n e e d + t o + t a k e + m e d i c a t i o n s + f o r + b o n e + d i s e a s e % 0 a a n e m i a + i s + a + v e r y + c o m m o n + c o m p l i c a t i o n + o f + c h r o n i c + r e n a l + f a i l u r e + t h e + k i d n e y s + m a k e + a + h o r m o n e + t h a t + t e l l s + t h e + b o n e + m a r r o w + t o + m a k e + r e d + b l o o d + c e l l s + a n d + t h i s + h o r m o n e + i s + n o t + p r o d u c e d + i n + s u f f i c i e n t + a m o u n t s + i n + c h i l d r e n + w i t h + c h r o n i c + r e n a l + f a i l u r e + t h u s % 2 c + c h i l d r e n + w i t h + c h r o n i c + r e n a l + f a i l u r e + g r a d u a l l y + b e c o m e + a n e m i c + w h i l e + t h e i r + c h r o n i c + r e n a l + f a i l u r e + i s + s l o w l y + p r o g r e s s i n g + t h e + a n e m i a + o f + c h r o n i c + r e n a l + f a i l u r e + i s + t r e a t e d + w i t h + h u m a n + r e c o m b i n a n t + e r y t h r o p o i e t i n + % 2 8 a + s h o t + g i v e n + u n d e r + t h e + s k i n + o n e + t o + t h r e e + t i m e s + a + w e e k + o r + o n c e + e v e r y + f e w + w e e k s + w i t h + a + l o n g e r + a c t i n g + h u m a n + r e c o m b i n a n t + e r y t h r o p o i e t i n % 2 9 % 0 a g r o w t h + f a i l u r e + u l t i m a t e l y + l e a d i n g + t o + s h o r t + h e i g h t + a s + a n + a d u l t + i s + a + v e r y + c o m m o n + c o m p l i c a t i o n + o f + c h r o n i c + r e n a l + f a i l u r e + i n + c h i l d r e n + t h e + m e c h a n i s m s + o f + g r o w t h + f a i l u r e + a r e + c o m p l e x + a n d + d u e + t o + m u l t i p l e + c a u s e s + p o o r l y + c o n t r o l l e d + r e n a l + o s t e o d y s t r o p h y + % 2 8 b o n e + d i s e a s e % 2 9 % 2 c + i n a d e q u a t e + n u t r i t i o n + % 2 8 i n s u f f i c i e n t + i n t a k e + o f + a d e q u a t e + c a l o r i e s % 2 9 % 2 c + c h r o n i c + a c i d o s i s + % 2 8 b l o o d + s y s t e m + t o o + a c i d % 2 9 + a n d + a b n o r m a l i t i e s + o f + t h e + g r o w t h + h o r m o n e + a x i s + % 2 8 g r o w t h + h o r m o n e + d e f i c i e n c y % 2 9 + a r e + e a c h + m a j o r + c o n t r i b u t o r s + t o + p o o r + g r o w t h + i n + t h e + c h i l d + w i t h + c h r o n i c + r e n a l + f a i l u r e + g r o w t h + h o r m o n e + t h e r a p y + w i t h + h u m a n + r e c o m b i n a n t + g r o w t h + h o r m o n e + h a s + b e e n + a p p r o v e d + f o r + u s e + i n + c h i l d r e n + w i t h + c h r o n i c + r e n a l + f a i l u r e + a n d + s u c h + t h e r a p y + h a s + b e e n + s h o w n + t o + a c c e l e r a t e + g r o w t h % 2 c + i n d u c e + p e r s i s t e n t + c a t c h + u p + g r o w t h + a n d + l e a d + t o + n o r m a l + a d u l t + h e i g h t + i n + c h i l d r e n + w i t h + c h r o n i c + r e n a l + f a i l u r e + g r o w t h + h o r m o n e + t h e r a p y + r e q u i r e s + g i v i n g + a + s h o t + u n d e r + t h e + s k i n + o n c e + a + d a y + c o m p l i c a t i o n s + o f + g r o w t h + h o r m o n e + t h e r a p y + a r e + r a r e + b u t + m a y + i n c l u d e + g l u c o s e + i n t o l e r a n c e + a n d + e x a c e r b a t i o n + o f + p o o r l y + c o n t r o l l e d + r e n a l + o s t e o d y s t r o p h y % 0 a % 0 a d i a l y s i s + a n d + k i d n e y + t r a n s p l a n t a t i o n % 0 a % 0 a r e n a l + r e p l a c e m e n t + t h e r a p y + c a n + b e + i n + t h e + f o r m + o f + d i a l y s i s + % 2 8 p e r i t o n e a l + d i a l y s i s + o r + h e m o d i a l y s i s % 2 9 + o r + r e n a l + t r a n s p l a n t a t i o n % 0 a i f + t h e + p a t i e n t + d o e s + n o t + h a v e + a + l i v i n g + r e l a t e d + d o n o r + f o r + t h e i r + f i r s t + k i d n e y + t r a n s p l a n t + a n d + w h e n + t h e y + n e e d + a + s e c o n d + k i d n e y + t r a n s p l a n t + a f t e r + l o s s + o f + t h e + f i r s t + t r a n s p l a n t % 2 c + t h e y + w i l l + n e e d + d i a l y s i s + u n t i l + a + s u b s e q u e n t + t r a n s p l a n t + c a n + b e + p e r f o r m e d + t h e + p a t i e n t + c a n + b e + o n + p e r i t o n e a l + d i a l y s i s + o r + o n + h e m o d i a l y s i s % 0 a p e r i t o n e a l + d i a l y s i s + h a s + b e e n + a + m a j o r + m o d a l i t y + o f + t h e r a p y + f o r + c h r o n i c + r e n a l + f a i l u r e + f o r + s e v e r a l + y e a r s + c o n t i n u o u s + a m b u l a t o r y + p e r i t o n e a l + d i a l y s i s + % 2 8 c a p d % 2 9 + a n d + a u t o m a t e d + p e r i t o n e a l + d i a l y s i s + a l s o + c a l l e d + c o n t i n u o u s + c y c l i n g + p e r i t o n e a l + d i a l y s i s + % 2 8 c c p d % 2 9 + a r e + t h e + m o s t + c o m m o n + f o r m s + o f + d i a l y s i s + t h e r a p y + u s e d + i n + c h i l d r e n + w i t h + c h r o n i c + r e n a l + f a i l u r e + i n + t h i s + f o r m + o f + d i a l y s i s % 2 c + a + c a t h e t e r + i s + p l a c e d + i n + t h e + p e r i t o n e a l + c a v i t y + % 2 8 a r e a + a r o u n d + t h e + s t o m a c h % 2 9 % 3 b + d i a l y s a t e + % 2 8 f l u i d + t o + c l e a n + t h e + b l o o d % 2 9 + i s + p l a c e d + i n t o + t h e + a b d o m e n + a n d + c h a n g e d + 4 + t o + 6 + t i m e s + a + d a y + p a r e n t s + a n d + a d o l e s c e n t s + a r e + a b l e + t o + p e r f o r m + c a p d % 2 f c c p d + a t + h o m e + p e r i t o n i t i s + % 2 8 i n f e c t i o n + o f + t h e + f l u i d % 2 9 + i s + a + m a j o r + c o m p l i c a t i o n + o f + p e r i t o n e a l + d i a l y s i s % 0 a h e m o d i a l y s i s + h a s + a l s o + b e e n + u s e d + f o r + s e v e r a l + y e a r s + f o r + t h e + t r e a t m e n t + o f + c h r o n i c + r e n a l + f a i l u r e + d u r i n g + c h i l d h o o d + d u r i n g + h e m o d i a l y s i s % 2 c + b l o o d + i s + t a k e n + o u t + o f + t h e + b o d y + b y + a + c a t h e t e r + o r + f i s t u l a + a n d + c i r c u l a t e d + i n + a n + a r t i f i c i a l + k i d n e y + t o + c l e a n + t h e + b l o o d + h e m o d i a l y s i s + i s + u s u a l l y + p e r f o r m e d + t h r e e + t i m e s + a + w e e k + f o r + 3 - 4 + h o u r s + e a c h + t i m e + i n + a + d i a l y s i s + u n i t % 0 a r e n a l + t r a n s p l a n t a t i o n + c a n + b e + f r o m + a + d e c e a s e d + o r + a + l i v i n g + r e l a t e d + d o n o r + % 2 8 p a r e n t + o r + s i b l i n g + w h o + i s + o v e r + t h e + a g e + o f + 1 8 + w h o + i s + c o m p a t i b l e % 2 9 + s h o u l d + t h e + p a t i e n t + h a v e + a + l i v i n g + r e l a t e d + d o n o r + a v a i l a b l e + t o + d o n a t e + a + k i d n e y % 2 c + t h e y + c a n + u n d e r g o + t r a n s p l a n t a t i o n + w i t h o u t + t h e + n e e d + f o r + d i a l y s i s + % 2 8 p r e e m p t i v e + t r a n s p l a n t a t i o n % 2 9 + s h o u l d + t h e y + n o t + h a v e + a + l i v i n g + r e l a t e d + d o n o r % 2 c + t h e y + w i l l + l i k e l y + n e e d + t o + u n d e r g o + d i a l y s i s + w h i l e + o n + t h e + w a i t i n g + l i s t + f o r + a + d e c e a s e d + d o n o r + t r a n s p l a n t + f o r t u n a t e l y % 2 c + c h i l d r e n + h a v e + t h e + s h o r t e s t + w a i t i n g + t i m e + o n + t h e + d e c e a s e d + d o n o r + t r a n s p l a n t + l i s t + t h e + a v e r a g e + w a i t i n g + t i m e + f o r + c h i l d r e n + a g e + 0 - 1 7 + y e a r s + i s + a p p r o x i m a t e l y + 2 7 5 - 3 0 0 + d a y s + w h i l e + t h e + a v e r a g e + w a i t i n g + t i m e + f o r + p a t i e n t % c 3 % a 2 % c 2 % 8 0 % c 2 % 9 9 s + a g e + 1 8 - 4 4 + y e a r s + i s + a p p r o x i m a t e l y + 7 0 0 + d a y s % 0 a f o l l o w i n g + t r a n s p l a n t a t i o n % 2 c + t h e + p a t i e n t + w i l l + n e e d + t o + t a k e + i m m u n o s u p p r e s s i v e + m e d i c a t i o n s + f o r + t h e + r e m a i n d e r + o f + t h e i r + l i f e + t o + p r e v e n t + r e j e c t i o n + o f + t h e + t r a n s p l a n t e d + k i d n e y + m e d i c a t i o n s + u s e d + t o + p r e v e n t + r e j e c t i o n + h a v e + c o n s i d e r a b l e + s i d e + e f f e c t s + c o r t i c o s t e r o i d s + a r e + c o m m o n l y + u s e d + f o l l o w i n g + t r a n s p l a n t a t i o n + t h e + s i d e + e f f e c t s + o f + c o r t i c o s t e r o i d s + a r e + c u s h i n g n o i d + f e a t u r e s + % 2 8 f a t + d e p o s i t i o n + a r o u n d + t h e + c h e e k s + a n d + a b d o m e n + a n d + b a c k % 2 9 % 2 c + w e i g h t + g a i n % 2 c + e m o t i o n a l + l i a b i l i t y % 2 c + c a t a r a c t s % 2 c + d e c r e a s e d + g r o w t h % 2 c + o s t e o m a l a c i a + a n d + o s t e o n e c r o s i s + % 2 8 s o f t e n i n g + o f + t h e + b o n e s + a n d + b o n e + p a i n % 2 9 % 2 c + h y p e r t e n s i o n % 2 c + a c n e + a n d + d i f f i c u l t y + i n + c o n t r o l l i n g + g l u c o s e + l e v e l s + t h e + s t e r o i d + s i d e + e f f e c t s % 2 c + p a r t i c u l a r l y + t h e + e f f e c t s + o n + a p p e a r a n c e % 2 c + a r e + d i f f i c u l t + f o r + c h i l d r e n % 2 c + e s p e c i a l l y + t e e n a g e r s % 2 c + a n d + n o n + c o m p l i a n c e + d o + t o + t h e + s i d e + e f f e c t s + o f + m e d i c a t i o n s + i s + a + r i s k + i n + c h i l d r e n % 3 b + a g a i n % 2 c + p a r t i c u l a r l y + t e e n a g e r s % 0 a c y c l o s p o r i n e + a n d % 2 f o r + t a c r o l i m u s + a r e + a l s o + c o m m o n l y + u s e d + a s + i m m u n o s u p p r e s s i v e + m e d i c a t i o n s + f o l l o w i n g + t r a n s p l a n t a t i o n + s i d e + e f f e c t s + o f + t h e s e + d r u g s + i n c l u d e + h i r s u t i s m + % 2 8 i n c r e a s e d + h a i r + g r o w t h % 2 9 % 2 c + g u m + h y p e r t r o p h y % 2 c + i n t e r s t i t i a l + f i b r o s i s + i n + t h e + k i d n e y + % 2 8 d a m a g e + t o + t h e + k i d n e y % 2 9 % 2 c + a s + w e l l + a s + o t h e r + c o m p l i c a t i o n s + m e c l o p h e n a l a t e + i s + a l s o + c o m m o n l y + u s e d + a f t e r + t r a n s p l a n t a t i o n + % 2 8 s o m e t i m e s + i m u r a n + i s + u s e d % 2 9 % 3 b + e a c h + o f + t h e s e + d r u g s + c a n + c a u s e + a + l o w + w h i t e + b l o o d + c e l l + c o u n t + a n d + i n c r e a s e d + s u s c e p t i b i l i t y + t o + i n f e c t i o n + m a n y + o t h e r + i m m u n o s u p p r e s s i v e + m e d i c a t i o n s + a n d + o t h e r + m e d i c a t i o n s + % 2 8 a n t i - h y p e r t e n s i v e + a g e n t s % 2 c + a n t i - a c i d s % 2 c + e t c % 2 9 + a r e + p r e s c r i b e d + i n + t h e + p o s t o p e r a t i v e + p e r i o d % 0 a l i f e + l o n g + i m m u n o s u p p r e s s i o n % 2 c + a s + u s e d + i n + p a t i e n t s + w i t h + k i d n e y + t r a n s p l a n t s % 2 c + i s + a s s o c i a t e d + w i t h + s e v e r a l + c o m p l i c a t i o n s + i n c l u d i n g + a n + i n c r e a s e d + s u s c e p t i b i l i t y + t o + i n f e c t i o n % 2 c + a c c e l e r a t e d + a t h e r o s c l e r o s i s + % 2 8 h a r d e n i n g + o f + t h e + a r t e r i e s % 2 9 % 2 c + i n c r e a s e d + i n c i d e n c e + o f + m a l i g n a n c y + % 2 8 c a n c e r % 2 9 + a n d + c h r o n i c + r e j e c t i o n + o f + t h e + k i d n e y % 0 a u n i t e d + s t a t e s + r e n a l + d a t a + s y s t e m s + % 2 8 u s r d s % 2 9 + r e p o r t + t h a t + t h e + h a l f - l i f e + % 2 8 t i m e + a t + w h i c h + 5 0 % 2 5 + o f + t h e + k i d n e y s + a r e + s t i l l + f u n c t i o n i n g + a n d + 5 0 % 2 5 + h a v e + s t o p p e d + f u n c t i o n i n g % 2 9 + i s + 1 0 5 + y e a r s + f o r + a + d e c e a s e d + t r a n s p l a n t + i n + c h i l d r e n + a g e + 0 - 1 7 + y e a r s + a n d + 1 5 5 + y e a r s + f o r + a + l i v i n g + r e l a t e d + t r a n s p l a n t + i n + c h i l d r e n + 0 - 1 7 + y e a r s + s i m i l a r + d a t a + f o r + a + t r a n s p l a n t + a t + a g e + 1 8 + t o + 4 4 + y e a r s + i s + 1 0 1 + y e a r s + a n d + 1 6 0 + y e a r s + f o r + a + d e c e a s e d + d o n o r + a n d + a + l i v i n g + r e l a t e d + d o n o r % 2 c + r e s p e c t i v e l y + t h u s % 2 c + d e p e n d i n g + u p o n + t h e + a g e + w h e n + t h e + p a t i e n t + r e c e i v e s + t h e i r + f i r s t + t r a n 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h a t + t h e + r i s k s + o f + l o n g e r + t e r m + % 2 8 m o r e + t h a n + 2 0 + y e a r s % 2 9 + c o m p l i c a t i o n s + a r e + u n k n o w n + a n d + a r e + l i k e l y + t o + b e + h i g h e r + t h a n + r i s k s + a t + 1 0 + y e a r s % 2 c + a s + m a n y + o f + t h e + a b o v e + s t u d i e s + d e s c r i b e % 0 a a + n e p h r o l o g i s t % c 3 % a 2 % c 2 % 8 0 % c 2 % 9 4 a + k i d n e y + s p e c i a l i s t % c 3 % a 2 % c 2 % 8 0 % c 2 % 9 4 s h o u l d + f o r m a l l y + e v a l u a t e + a l l + p e r s o n s + w h o + h a v e + e x p e r i e n c e d + h u s a t + a + y e a r + f o l l o w i n g + t h e i r + a c u t e + i l l n e s s + k i d n e y s + i n j u r e d + b y + h u s + m a y + s l o w l y + r e c o v e r + f u n c t i o n + o v e r + a t + l e a s t + a + s i x - m o n t h + p e r i o d + f o l l o w i n g + t h e + a c u t e + e p i s o d e + a n d + p e r h a p s + l o n g e r + e v e n + p e r s o n s + w i t h + % c 3 % a 2 % 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