The care of children with chronic renal insufficiency implies close cooperation between paediatric practitioners and paediatric units for renal disease. The children's disease must be detected at an early stage, its cause and course clarified. Adequate medical, psychological and social care during the period of compensated retention reduces complications at the beginning of dialysis- and transplant-programmes. At the moment good results in children justify the considerable expense. Many problems still remain unanswered as far as long term prognosis, growth, psychological, social, and sexual development are concerned.