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Achievements, priorities and strategies in pediatric nephrology in Europe: need for unifying approaches or acceptance of differences?

J. H. H. EhrichDepartment of Pediatric Kidney, Liver, Metabolic and Neurological Diseases, Children's Hospital, Hannover Medical School, Hannover, GermanyVelibor TasićViðar Ö. EðvarðssonIceland Children's Medical Center, Faculty of Medicine, School of Health Sciences, Landspitali, The National University Hospital of Iceland, University of Iceland, Reykjavik, IcelandEvgenia PrekaPaediatric Nephrology, University Hospital Southampton NHS Foundation Trust, Southampton, United KingdomLarisa PrikhodinaResearch and Clinical Institute for Pediatrics, Pirogov Russian National Research Medical University, Moscow, RussiaConstantinos J. StefanidisDivision of Pediatric Nephrology, Mitera Children's Hospital, Athens, GreeceRezan TopaloğluDepartment of Pediatric Nephrology, Hacettepe University School of Medicine, Ankara, TürkiyeDiamant ShtizaDivision of Pediatric Nephrology, University Hospital Centre "Mother Teresa", Tirana, AlbaniaAshot SarkissianArabkir Joint Medical Centre Yerevan, Yerevan State Medical University, Yerevan, ArmeniaThomas Mueller‐SachererDepartment of Pediatric Nephrology and Gastroenterology, Medical University of Vienna, Vienna, AustriaRena FataliyevaI. A. Kazyra1st Department of Pediatrics, Belarusian State Medical University, Minsk, BelarusElena LevtchenkoDepartment of Pediatrics & Division of Pediatric Nephrology, University Hospitals Leuven, Leuven, BelgiumDanka PokrajacDivision of Pediatric Nephrology, University Children's Hospital, Sarajevo, Bosnia and HerzegovinaDimitar RoussinovNephrology and Hemodialysis Clinic, Department of Pediatrics, Medical University of Sofia, Sofia, BulgariaDanko MiloševićPediatric Clinic, University Hospital Center Zagreb, Zagreb, CroatiaAvraam EliaDivision of Pediatric Nephrology, Makarios Children Hospital, Nicosia, CyprusTomáš SeemanDepartment of Pediatrics, 2nd Medical Faculty, Charles University Prague, Prague, Czech RepublicMia FærchDepartment of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, DenmarkInga VainumäeDepartment of Pediatrics, University of Tartu, Tartu, EstoniaJanne KatajaDepartment of Paediatrics and Adolescents Medicine, Turku University Hospital, Turku, FinlandMichel TsimaratosPediatric Nephrology Unit, Department of Multidisciplinary Pediatrics, Assistance Publique des Hôpitaux de Marseille, Marseille, FranceIrakli RtskhiladzePeter F. HoyerDepartment of Pediatric Nephrology, University Hospital Essen, Essen, GermanyGyörgy ReuszFirst Department of Pediatrics, Semmelweis University, Budapest, HungaryAtif AwanDivision of Pediatric Nephrology, Children's Health Ireland (CHI) at Temple Street, Dublin, IrelandDanny LotanDivision of Pediatric Nephrology, Sheba Medical Center, Edmond and Lily Children's Hospital, Tel Hashomer, IsraelLicia PeruzziDivision of Pediatric Nephrology, Regina Margherita Children's Hospital, Torino, ItalyNazym NigmatullinaDepartment of Nephrology, Kazakh National Medical University, Almaty, KazakhstanNasira BeishebaevaEdite JerumaAugustina JankauskienėPediatric Center, Institute of Clinical Medicine, Vilnius University, Vilnius, LithuaniaOlivier NielPediatric Nephrology, Centre Hospitalier de Luxembourg, Luxembourg, LuxembourgValerie Said-ContiDepartment of Child and Adolescent Health, Mater Dei Hospital, Msida, MaltaAngela CiuntuSnežana PavićevićClinical Center of Montenegro, Institute for Sick Children, Podgorica, MontenegroMichiel J.S. OosterveldDepartment of Paediatric Nephrology, Emma Children's Hospital Amsterdam University Medical Center, Amsterdam, NetherlandsAnna BjerreDepartment of Pediatric and Adolescent Medicine, University Hospital of Oslo, Oslo, NorwayMarcin TkaczykDepartment of Pediatrics, Immunology and Nephrology, Polish Mother's Memorial Hospital Research Institute, Lodz, PolandAna TeixeiraPediatric Nephrology Division, Centro Hospitalar Universitário do Porto, Porto, PortugalAdrian LunguPediatric Nephrology, Fundeni Clincal Institute, Bucharest, RomaniaА.Н. ЦыгинVesna StojanovićDivision of Pediatric Nephrology, Institute for Child and Youth Health Care of Vojvodina Novi Sad, Novi Sad, SerbiaĽudmila PodrackáDepartment of Pediatrics, Comenius University, Bratislava, SlovakiaTanja Kersnik LevartPediatric Nephrology Department, Children's Hospital, University Medical Centre Ljubljana, Ljubljana, SloveniaM. Espino HernándezPediatric Nephrology, Pediatrics, University Hospital 12 Octubre, Madrid, SpainPer BrandströmPediatric Uro-Nephrologic Center, Department of Pediatrics, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, SwedenGiuseppina SpartàDepartment of Pediatric Nephrology, University Children's Hospital, Zurich, SwitzerlandHarika AlpayDivision of Pediatric Nephrology, Marmara University, Istanbul, TürkiyeД.Д. ІвановNephrology and RRT Department, Shupyk National Healthcare University of Ukraine, Kyiv, UkraineJan DudleyDivision of Pediatric Nephrology, Bristol Royal Hospital for Children, Bristol, United KingdomKomiljon KhamzaevDivision of Pediatric Nephrology, Pediatric Medical Institute, Tashkent, UzbekistanDieter HaffnerDepartment of Pediatric Kidney, Liver, Metabolic and Neurological Diseases, Children's Hospital, Hannover Medical School, Hannover, Germany
Frontiers in Pediatricsjournal2024en
ABI

Аннотация

Background: There is a lack of information on the current healthcare systems for children with kidney diseases across Europe. The aim of this study was to explore the different national approaches to the organization and delivery of pediatric nephrology services within Europe. Methods: In 2020, the European society for Paediatric Nephrology (ESPN) conducted a cross-sectional survey to identify the existing pediatric nephrology healthcare systems in 48 European countries covering a population of more than 200 million children. Results: The reported three most important priorities in the care of children with kidney diseases were better training of staff, more incentives for physicians to reduce staff shortages, and more hospital beds. Positive achievements in the field of pediatric nephrology included the establishment of new specialized pediatric nephrology centers, facilities for pediatric dialysis and transplant units in 18, 16, and 12 countries, respectively. The most common problems included no access to any type of dialysis (12), inadequate transplant programs for all ages of children (12), lack of well-trained physicians and dialysis nurses (12), inadequate reimbursement of hospitals for expensive therapies (10), and lack of multidisciplinary care by psychologists, dieticians, physiotherapists, social workers and vocational counsellors (6). Twenty-five of 48 countries (52%) expected to have a shortage of pediatric nephrologists in the year 2025, 63% of clinical nurses and 56% of dialysis nurses. All three groups of health care professionals were expected to be lacking in 38% of countries. Prenatal assessment and postnatal management of renal malformations by a multidisciplinary team including obstetricians, geneticists, pediatricians, and pediatric surgeons was available in one third of countries. Conclusions: Our study shows that there are still very marked differences in pediatric health care systems across the European countries and highlights the need need for appropriate services for children with kidney disease in all European countries.

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