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. 2024 Dec 20:12:1458003.
doi: 10.3389/fped.2024.1458003. eCollection 2024.

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

Jochen Ehrich  1 , Velibor Tasic  2 , Vidar O Edvardsson  3 , Evgenia Preka  4 , Larisa Prikhodina  5 , Constantinos J Stefanidis  6 , Rezan Topaloglu  7 , Diamant Shtiza  8 , Ashot Sarkissian  9 , Thomas Mueller-Sacherer  10 , Rena Fataliyeva  11 , Ina Kazyra  12 , Elena Levtchenko  13 , Danka Pokrajac  14 , Dimitar Roussinov  15 , Danko Milošević  16 , Avraam Elia  17 , Tomas Seeman  18 , Mia Faerch  19 , Inga Vainumae  20 , Janne Kataja  21 , Michel Tsimaratos  22 , Irakli Rtskhiladze  23 , Peter F Hoyer  24 , George Reusz  25 , Atif Awan  26 , Danny Lotan  27 , Licia Peruzzi  28 , Nazym Nigmatullina  29 , Nasira Beishebaeva  30 , Edite Jeruma  31 , Augustina Jankauskiene  32 , Olivier Niel  33 , Valerie Said-Conti  34 , Angela Ciuntu  35 , Snežana Pavićević  36 , Michiel Oosterveld  37 , Anna Bjerre  38 , Marcin Tkaczyk  39 , Ana Teixeira  40 , Adrian C Lungu  41 , Alexey Tsygin  42 , Vesna Stojanović  43 , Ludmila Podracka  44 , Tanja Kersnik Levart  45 , Mar Espino-Hernández  46 , Per Brandström  47 , Giuseppina Sparta  48 , Harika Alpay  49 , Dmytro Ivanov  50 , Jan Dudley  51 , Komiljon Khamzaev  52 , Dieter Haffner  1
Affiliations

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

Jochen Ehrich et al. Front Pediatr. .

Abstract

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.

Keywords: European child healthcare services; achievements; needs; nephrology; prevention; rehabilitation; workforce.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

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