Achievements, priorities and strategies in pediatric nephrology in Europe: need for unifying approaches or acceptance of differences?
Ehrich J. Tasic V. Edvardsson V.O. Preka E. Prikhodina L. Stefanidis C.J. Topaloglu R. Shtiza D. Sarkissian A. Mueller-Sacherer T. Fataliyeva R. Kazyra I. Levtchenko E. Pokrajac D. Roussinov D. Milošević D. Elia A. Seeman T. Faerch M. Vainumae I. Kataja J. Tsimaratos M. Rtskhiladze I. Hoyer P.F. Reusz G. Awan A. Lotan D. Peruzzi L. Nigmatullina N. Beishebaeva N. Jeruma E. Jankauskiene A. Niel O. Said-Conti V. Ciuntu A. Pavićević S. Oosterveld M. Bjerre A. Tkaczyk M. Teixeira A. Lungu A.C. Tsygin A. Stojanović V. Podracka L. Levart T.K. Espino-Hernández M. Brandström P. Sparta G. Alpay H. Ivanov D. Dudley J. Khamzaev K. Haffner D.
2024Frontiers Media SA
Frontiers in Pediatrics
2024#12
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. 2024 Ehrich, Tasic, Edvardsson, Preka, Prikhodina, Stefanidis, Topaloglu, Shtiza, Sarkissian, Mueller-Sacherer, Fataliyeva, Kazyra, Levtchenko, Pokrajac, Roussinov, Milošević, Elia, Seeman, Faerch, Vainumae, Kataja, Tsimaratos, Rtskhiladze, Hoyer, Reusz, Awan, Lotan, Peruzzi, Nigmatullina, Beishebaeva, Jeruma, Jankauskiene, Niel, Said-Conti, Ciuntu, Pavićević, Oosterveld, Bjerre, Tkaczyk, Teixeira, Lungu, Tsygin, Stojanović, Podracka, Levart, Espino-Hernández, Brandström, Sparta, Alpay, Ivanov, Dudley, Khamzaev and Haffner.
achievements , European child healthcare services , needs , nephrology , prevention , rehabilitation , workforce
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Department of Pediatric Kidney, Metabolic and Neurological Diseases, Children’s Hospital, Hannover Medical School, Hannover, Liver, Germany
Medical School, University Children’s Hospital, Skopje, North Macedonia
Iceland Children’s Medical Center, Faculty of Medicine, School of Health Sciences, Landspitali, The National University Hospital of Iceland, University of Iceland, Reykjavik, Iceland
Paediatric Nephrology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
Research and Clinical Institute for Pediatrics, Pirogov Russian National Research Medical University, Moscow, Russian Federation
Division of Pediatric Nephrology, Mitera Children’s Hospital, Athens, Greece
Department of Pediatric Nephrology, Hacettepe University School of Medicine, Ankara, Turkey
Division of Pediatric Nephrology, University Hospital Centre “Mother Teresa”, Tirana, Albania
Arabkir Joint Medical Centre Yerevan, Yerevan State Medical University, Yerevan, Armenia
Department of Pediatric Nephrology and Gastroenterology, Medical University of Vienna, Vienna, Austria
Division of Pediatric Nephrology, Children’s Hospital, Baku, Azerbaijan
1st Department of Pediatrics, Belarusian State Medical University, Minsk, Belarus
Department of Pediatrics & Division of Pediatric Nephrology, University Hospitals Leuven, Leuven, Belgium
Division of Pediatric Nephrology, University Children’s Hospital, Sarajevo, Bosnia and Herzegovina
Nephrology and Hemodialysis Clinic, Department of Pediatrics, Medical University of Sofia, Sofia, Bulgaria
Pediatric Clinic, University Hospital Center Zagreb, Zagreb, Croatia
Division of Pediatric Nephrology, Makarios Children Hospital, Nicosia, Cyprus
Department of Pediatrics, 2nd Medical Faculty, Charles University Prague, Prague, Czech Republic
Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
Department of Pediatrics, University of Tartu, Tartu, Estonia
Department of Paediatrics and Adolescents Medicine, Turku University Hospital, Turku, Finland
Pediatric Nephrology Unit, Department of Multidisciplinary Pediatrics, Assistance Publique des Hôpitaux de Marseille, Marseille, France
Division of Pediatric Nephrology, Medical Centre Mrcheveli, Tbilisi, Georgia
Department of Pediatric Nephrology, University Hospital Essen, Essen, Germany
First Department of Pediatrics, Semmelweis University, Budapest, Hungary
Division of Pediatric Nephrology, Children’s Health Ireland (CHI) at Temple Street, Dublin, Ireland
Division of Pediatric Nephrology, Sheba Medical Center, Edmond and Lily Children’s Hospital, Tel Hashomer, Israel
Division of Pediatric Nephrology, Regina Margherita Children’s Hospital, Torino, Italy
Department of Nephrology, Kazakh National Medical University, Almaty, Kazakhstan
Division of Pediatric Nephrology, Maternity and Child Welfare National Center Under the Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan
Division of Pediatric Nephrology, Bērnuslimībuklīnika, Nefroloģi Jasprofilavirsārste, Riga, Latvia
Pediatric Center, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
Pediatric Nephrology, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
Department of Child and Adolescent Health, Mater Dei Hospital, Msida, Malta
Nephrology Unit, National Institute of Health Care for Mother and Child, Chisinau, Moldova
Clinical Center of Montenegro, Institute for Sick Children, Podgorica, Montenegro
Department of Paediatric Nephrology, Emma Children’s Hospital Amsterdam University Medical Center, Amsterdam, Netherlands
Department of Pediatric and Adolescent Medicine, University Hospital of Oslo, Oslo, Norway
Department of Pediatrics, Immunology and Nephrology, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
Pediatric Nephrology Division, Centro Hospitalar Universitário do Porto, Porto, Portugal
Pediatric Nephrology, Fundeni Clincal Institute, Bucharest, Romania
Division of Pediatric Nephrology, Institute of Pediatrics NCZD, Moscow, Russian Federation
Division of Pediatric Nephrology, Institute for Child and Youth Health Care of Vojvodina Novi Sad, Novi Sad, Serbia
Department of Pediatrics, Comenius University, Bratislava, Slovakia
Pediatric Nephrology Department, Children’s Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
Pediatric Nephrology, Pediatrics, University Hospital 12 Octubre, Madrid, Spain
Pediatric Uro-Nephrologic Center, Department of Pediatrics, Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
Department of Pediatric Nephrology, University Children’s Hospital, Zurich, Switzerland
Division of Pediatric Nephrology, Marmara University, Istanbul, Turkey
Nephrology and RRT Department, Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
Division of Pediatric Nephrology, Bristol Royal Hospital for Children, Bristol, United Kingdom
Division of Pediatric Nephrology, Pediatric Medical Institute, Tashkent, Uzbekistan
Department of Pediatric Kidney
Medical School
Iceland Children’s Medical Center
Paediatric Nephrology
Research and Clinical Institute for Pediatrics
Division of Pediatric Nephrology
Department of Pediatric Nephrology
Division of Pediatric Nephrology
Arabkir Joint Medical Centre Yerevan
Department of Pediatric Nephrology and Gastroenterology
Division of Pediatric Nephrology
1st Department of Pediatrics
Department of Pediatrics & Division of Pediatric Nephrology
Division of Pediatric Nephrology
Nephrology and Hemodialysis Clinic
Pediatric Clinic
Division of Pediatric Nephrology
Department of Pediatrics
Department of Pediatrics and Adolescent Medicine
Department of Pediatrics
Department of Paediatrics and Adolescents Medicine
Pediatric Nephrology Unit
Division of Pediatric Nephrology
Department of Pediatric Nephrology
First Department of Pediatrics
Division of Pediatric Nephrology
Division of Pediatric Nephrology
Division of Pediatric Nephrology
Department of Nephrology
Division of Pediatric Nephrology
Division of Pediatric Nephrology
Pediatric Center
Pediatric Nephrology
Department of Child and Adolescent Health
Nephrology Unit
Clinical Center of Montenegro
Department of Paediatric Nephrology
Department of Pediatric and Adolescent Medicine
Department of Pediatrics
Pediatric Nephrology Division
Pediatric Nephrology
Division of Pediatric Nephrology
Division of Pediatric Nephrology
Department of Pediatrics
Pediatric Nephrology Department
Pediatric Nephrology
Pediatric Uro-Nephrologic Center
Department of Pediatric Nephrology
Division of Pediatric Nephrology
Nephrology and RRT Department
Division of Pediatric Nephrology
Division of Pediatric Nephrology
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