Management Dilemmas in Pediatric Nephrology: Moving from Friction to Flourishing in "challenging" Cases

Overview

Journal Pediatr Nephrol

Specialties Nephrology
Pediatrics

Date 2024 Apr 26

PMID 38668777

Authors

Celina Brunson

Taylor R House

Damien Noone

Aaron Wightman

Affiliations

Soon will be listed here.

Abstract

Background: The circumstances surrounding chronic kidney disease and its impact on families can be complex and difficult to navigate, leading to these cases being labeled "challenging."

Case Presentation: We present the case of an adolescent with kidney failure due to unremitting systemic illness and multiple complications ultimately resulting in the family's request to forgo dialysis. Medical team members wrestled with meeting the family's needs among internal and external constraints.

Conclusion: Past experiences, systemic inequities, differing perspectives, and consequential decision-making within individual belief systems can lead to friction between and among medical team members and families. As pediatric nephrologists, we must shift our focus from the "challenging" patient or family to addressing what is challenging their ability to flourishing.

Citing Articles

Responding to ethical dilemmas in pediatric nephrology: a framework for clinicians in varied practice settings.

Pais P, Lanewala A, Levy C, Wightman A Pediatr Nephrol. 2025; .

PMID: 39966138 DOI: 10.1007/s00467-024-06649-2.

Now what: navigating care of maternal/fetal dyads with bilateral renal agenesis after RAFT. A physician and parent point of view.

Munshi R, Turner K, Berrettini A, Weiss E Pediatr Nephrol. 2024; 40(2):291-295.

PMID: 39043966 DOI: 10.1007/s00467-024-06460-z.

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