Caring for adolescent renal patients.

Adolescent patients who require the care of a nephrologist present with a variety of challenges. For the treating physician, it is important to be competent in relevant principles of adolescent physiology, such as somatic growth and puberty. It is also essential to be familiar with the stages of adolescent emotional and intellectual development, and their influence on behavior and adherence. Patients transitioning from pediatric nephrology may experience difficulties adjusting to the adult care system. Although the renal pathology of adolescents has more in common with that of adults than that of prepubertal children, there are unique epidemiological, diagnostic, and treatment approaches to these patients that should be considered. Membranous glomerulonephritis and diabetic nephropathy are rare in adolescents, whereas IgA and systemic lupus erythematosus are often important differential diagnoses. Despite all of the challenges posed by adolescents, there is a real prospect of intervening early in the course of chronic kidney disease with the potential to alleviate long-term morbidity.