Frontiers in Pediatrics (Dec 2024)
Achievements, priorities and strategies in pediatric nephrology in Europe: need for unifying approaches or acceptance of differences?
- Jochen Ehrich,
- Velibor Tasic,
- Vidar O. Edvardsson,
- Evgenia Preka,
- Larisa Prikhodina,
- Constantinos J. Stefanidis,
- Rezan Topaloglu,
- Diamant Shtiza,
- Ashot Sarkissian,
- Thomas Mueller-Sacherer,
- Rena Fataliyeva,
- Ina Kazyra,
- Elena Levtchenko,
- Danka Pokrajac,
- Dimitar Roussinov,
- Danko Milošević,
- Avraam Elia,
- Tomas Seeman,
- Mia Faerch,
- Inga Vainumae,
- Janne Kataja,
- Michel Tsimaratos,
- Irakli Rtskhiladze,
- Peter F. Hoyer,
- George Reusz,
- Atif Awan,
- Danny Lotan,
- Licia Peruzzi,
- Nazym Nigmatullina,
- Nasira Beishebaeva,
- Edite Jeruma,
- Augustina Jankauskiene,
- Olivier Niel,
- Valerie Said-Conti,
- Angela Ciuntu,
- Snežana Pavićević,
- Michiel Oosterveld,
- Anna Bjerre,
- Marcin Tkaczyk,
- Ana Teixeira,
- Adrian C. Lungu,
- Alexey Tsygin,
- Vesna Stojanović,
- Ludmila Podracka,
- Tanja Kersnik Levart,
- Mar Espino-Hernández,
- Per Brandström,
- Giuseppina Sparta,
- Harika Alpay,
- Dmytro Ivanov,
- Jan Dudley,
- Komiljon Khamzaev,
- Dieter Haffner
Affiliations
- Jochen Ehrich
- Department of Pediatric Kidney, Liver, Metabolic and Neurological Diseases, Children’s Hospital, Hannover Medical School, Hannover, Germany
- Velibor Tasic
- Medical School, University Children’s Hospital, Skopje, North Macedonia
- Vidar O. Edvardsson
- Iceland Children’s Medical Center, Faculty of Medicine, School of Health Sciences, Landspitali, The National University Hospital of Iceland, University of Iceland, Reykjavik, Iceland
- Evgenia Preka
- Paediatric Nephrology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
- Larisa Prikhodina
- Research and Clinical Institute for Pediatrics, Pirogov Russian National Research Medical University, Moscow, Russia
- Constantinos J. Stefanidis
- Division of Pediatric Nephrology, Mitera Children’s Hospital, Athens, Greece
- Rezan Topaloglu
- Department of Pediatric Nephrology, Hacettepe University School of Medicine, Ankara, Türkiye
- Diamant Shtiza
- Division of Pediatric Nephrology, University Hospital Centre “Mother Teresa”, Tirana, Albania
- Ashot Sarkissian
- Arabkir Joint Medical Centre Yerevan, Yerevan State Medical University, Yerevan, Armenia
- Thomas Mueller-Sacherer
- 0Department of Pediatric Nephrology and Gastroenterology, Medical University of Vienna, Vienna, Austria
- Rena Fataliyeva
- 1Division of Pediatric Nephrology, Children’s Hospital, Baku, Azerbaijan
- Ina Kazyra
- 21st Department of Pediatrics, Belarusian State Medical University, Minsk, Belarus
- Elena Levtchenko
- 3Department of Pediatrics & Division of Pediatric Nephrology, University Hospitals Leuven, Leuven, Belgium
- Danka Pokrajac
- 4Division of Pediatric Nephrology, University Children’s Hospital, Sarajevo, Bosnia and Herzegovina
- Dimitar Roussinov
- 5Nephrology and Hemodialysis Clinic, Department of Pediatrics, Medical University of Sofia, Sofia, Bulgaria
- Danko Milošević
- 6Pediatric Clinic, University Hospital Center Zagreb, Zagreb, Croatia
- Avraam Elia
- 7Division of Pediatric Nephrology, Makarios Children Hospital, Nicosia, Cyprus
- Tomas Seeman
- 8Department of Pediatrics, 2nd Medical Faculty, Charles University Prague, Prague, Czech Republic
- Mia Faerch
- 9Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
- Inga Vainumae
- 0Department of Pediatrics, University of Tartu, Tartu, Estonia
- Janne Kataja
- 1Department of Paediatrics and Adolescents Medicine, Turku University Hospital, Turku, Finland
- Michel Tsimaratos
- 2Pediatric Nephrology Unit, Department of Multidisciplinary Pediatrics, Assistance Publique des Hôpitaux de Marseille, Marseille, France
- Irakli Rtskhiladze
- 3Division of Pediatric Nephrology, Medical Centre Mrcheveli, Tbilisi, Georgia
- Peter F. Hoyer
- 4Department of Pediatric Nephrology, University Hospital Essen, Essen, Germany
- George Reusz
- 5First Department of Pediatrics, Semmelweis University, Budapest, Hungary
- Atif Awan
- 6Division of Pediatric Nephrology, Children’s Health Ireland (CHI) at Temple Street, Dublin, Ireland
- Danny Lotan
- 7Division of Pediatric Nephrology, Sheba Medical Center, Edmond and Lily Children’s Hospital, Tel Hashomer, Israel
- Licia Peruzzi
- 8Division of Pediatric Nephrology, Regina Margherita Children’s Hospital, Torino, Italy
- Nazym Nigmatullina
- 9Department of Nephrology, Kazakh National Medical University, Almaty, Kazakhstan
- Nasira Beishebaeva
- 0Division of Pediatric Nephrology, Maternity and Child Welfare National Center Under the Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan
- Edite Jeruma
- 1Division of Pediatric Nephrology, Bērnuslimībuklīnika, Nefroloģi Jasprofilavirsārste, Riga, Latvia
- Augustina Jankauskiene
- 2Pediatric Center, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
- Olivier Niel
- 3Pediatric Nephrology, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
- Valerie Said-Conti
- 4Department of Child and Adolescent Health, Mater Dei Hospital, Msida, Malta
- Angela Ciuntu
- 5Nephrology Unit, National Institute of Health Care for Mother and Child, Chisinau, Moldova
- Snežana Pavićević
- 6Clinical Center of Montenegro, Institute for Sick Children, Podgorica, Montenegro
- Michiel Oosterveld
- 7Department of Paediatric Nephrology, Emma Children’s Hospital Amsterdam University Medical Center, Amsterdam, Netherlands
- Anna Bjerre
- 8Department of Pediatric and Adolescent Medicine, University Hospital of Oslo, Oslo, Norway
- Marcin Tkaczyk
- 9Department of Pediatrics, Immunology and Nephrology, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
- Ana Teixeira
- 0Pediatric Nephrology Division, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Adrian C. Lungu
- 1Pediatric Nephrology, Fundeni Clincal Institute, Bucharest, Romania
- Alexey Tsygin
- 2Division of Pediatric Nephrology, Institute of Pediatrics NCZD, Moscow, Russia
- Vesna Stojanović
- 3Division of Pediatric Nephrology, Institute for Child and Youth Health Care of Vojvodina Novi Sad, Novi Sad, Serbia
- Ludmila Podracka
- 4Department of Pediatrics, Comenius University, Bratislava, Slovakia
- Tanja Kersnik Levart
- 5Pediatric Nephrology Department, Children’s Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Mar Espino-Hernández
- 6Pediatric Nephrology, Pediatrics, University Hospital 12 Octubre, Madrid, Spain
- Per Brandström
- 7Pediatric Uro-Nephrologic Center, Department of Pediatrics, Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
- Giuseppina Sparta
- 8Department of Pediatric Nephrology, University Children’s Hospital, Zurich, Switzerland
- Harika Alpay
- 9Division of Pediatric Nephrology, Marmara University, Istanbul, Türkiye
- Dmytro Ivanov
- 0Nephrology and RRT Department, Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
- Jan Dudley
- 1Division of Pediatric Nephrology, Bristol Royal Hospital for Children, Bristol, United Kingdom
- Komiljon Khamzaev
- 2Division of Pediatric Nephrology, Pediatric Medical Institute, Tashkent, Uzbekistan
- Dieter Haffner
- Department of Pediatric Kidney, Liver, Metabolic and Neurological Diseases, Children’s Hospital, Hannover Medical School, Hannover, Germany
- DOI
- https://doi.org/10.3389/fped.2024.1458003
- Journal volume & issue
-
Vol. 12
Abstract
BackgroundThere 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.MethodsIn 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.ResultsThe 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.ConclusionsOur 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