TY - JOUR T1 - Renal replacement therapy and conservative management: NICE guideline (NG 107) October 2018 JF - Archives of disease in childhood - Education & practice edition JO - Arch Dis Child Educ Pract Ed SP - 352 LP - 354 DO - 10.1136/archdischild-2019-316892 VL - 105 IS - 6 AU - Zainab Arslan AU - Muhammad A Khurram AU - Manish D Sinha Y1 - 2020/12/01 UR - http://ep.bmj.com/content/105/6/352.abstract N2 - In 2017, 966 children in the UK received long-term renal replacement therapy (RRT) for established end-stage kidney disease (ESKD); 76% of whom had functioning renal transplants while 24% were on dialysis (13% on haemodialysis (HD) and 11% on peritoneal dialysis (PD)).1 The National Institute for Health and Care Excellence (NICE) published its guidance ‘Renal replacement therapy and conservative management’ in October 2018 (NG 107, 2018).Information about the clinical guidelineThe guideline caters to both adult and paediatric populations with stages 4 and 5 chronic kidney disease (CKD) (defined as an estimated glomerular filtration rate (eGFR) between 15–29 and <15 mL/min/1.73 m2 2) and provides recommendations on initiation, preparation, choice, switching or stopping modalities for RRT. It also provides information for patients and coordinating care when commencing RRT. The guideline mainly targets healthcare professionals looking after the patients and their families with CKD stages 4 and 5.Previous guidelinesThe British Association for Paediatric Nephrology3 4 and more recently the Renal Association (2017)5 have produced guidance for HD and PD, respectively, in children. This guidance replaces previous NICE guidance CG125 and TA48 (NICE, 2011) (box 1).Box 1 ResourcesNICE (NG 107) (2018). Renal replacement therapy and conservative management. Accessed online https://www.nice.org.uk/guidance/ng107.NICE (CG 125) (2011). Chronic kidney disease (stage 5): peritoneal dialysis. Accessed online https://www.nice.org.uk/guidance/cg125.NICE (TA48) (2011). Improving Choice for Kidney Patients and Carers - Increasing access to home dialysis. Accessed online https://www.nice.org.uk/contents/item/display/30787.Joint decision-making involving the child/young person, their parents and the multidisciplinary team (MDT) is recommended at all the stages. The key points highlighted in this guideline relating to paediatric population are:Indications for starting dialysisConsider starting dialysis when indicated by … ER -