Renal replacement therapy (RRT) is an effective modality for treatment of acute kidney injury (AKI) and chronic kidney disease (CKD) in pediatric populations. Improvements in technology, clinical skills, and management options have allowed for increased viability and usage of dialysis in the pediatric population prior to transplantation. In the United States, the incidence rate of end stage renal disease (ESRD) has decreased from 13 per million population (pmp) in 2010 to 11 pmp in 2020, though the adjusted incidence and prevalence of renal failure in pediatric patients (<18 years) remains significant at 11 and 76 per million age-related population (pmarp).¹

Advances in technology have allowed for increased flexibility in treatment and for the ability for patients to utilize home-based care provided largely by family caregivers vs. a hospital setting. Caregivers of children on RRT carry a significant burden to become healthcare providers in order to manage strict dietary and fluid limitations and administer medication as well as carrying the emotional toll of caring for a chronically ill child. The World Federation of Mental Health emphasizes the necessity of providing psychological assistance to caregivers of individuals with chronic illnesses, as these individuals are more susceptible to experiencing compromised health, increased incidence of chronic illnesses, diminished immune function, and elevated levels of exhaustion.² Better understanding of the caregiver experience will allow for better care of this unique population.

肾脏替代疗法（RRT）是治疗儿童急性肾损伤（AKI）和慢性肾病（CKD）的有效方法。技术、临床技能和管理方案的改进提高了儿科人群移植前透析的可行性和使用率。在美国，终末期肾病 (ESRD) 的发病率已从 2010 年的每百万人口 (pmp) 13 人下降到 2020 年的 11 人，尽管调整后儿童患者（<18 岁）肾衰竭的发病率和患病率）仍然显着，每百万年龄相关人口中有 11 人和 76 人（pmarp）。¹

技术的进步提高了治疗的灵活性，并使患者能够利用主要由家庭护理人员提供的家庭护理，而不是医院环境。接受 RRT 的儿童的照顾者承担着成为医疗保健提供者的沉重负担，以便管理严格的饮食和液体限制并管理药物，并承受照顾慢性病儿童的情感损失。世界心理健康联合会强调为慢性病患者的护理人员提供心理援助的必要性，因为这些人更容易出现健康受损、慢性病发病率增加、免疫功能减弱和疲劳程度升高的情况。²更好地了解护理人员的体验将有助于更好地护理这一独特人群。