Challenges of access to kidney care for children in low-resource settings

Kidney disease is a global public health concern across the age spectrum, including in children. However, our understanding of the true burden of kidney disease in low-resource areas is often hampered by a lack of disease awareness and access to diagnosis. Chronic kidney disease (CKD) in low-resourc...

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Bibliographic Details
Published in:Nature reviews. Nephrology 2021-01, Vol.17 (1), p.33-45
Main Authors: McCulloch, Mignon, Luyckx, Valerie A, Cullis, Brett, Davies, Simon J, Finkelstein, Fredric O, Yap, Hui Kim, Feehally, John, Smoyer, William E
Format: Article
Language:English
Subjects:
Acute Kidney Injury - diagnosis
Acute Kidney Injury - therapy
Adolescent
Care and treatment
Child
Child, Preschool
Children
Cost-Benefit Analysis
Developing Countries
Diagnosis
Diseases
Early Diagnosis
Early Medical Intervention
Glomerulonephritis - diagnosis
Glomerulonephritis - therapy
Health Resources
Health Services Accessibility
Health Workforce
Humans
Immunosuppressive Agents - supply & distribution
Kidney diseases
Kidney Transplantation
Nephrology
Peritoneal Dialysis - economics
Peritoneal Dialysis - instrumentation
Peritoneal Dialysis - methods
Renal Insufficiency, Chronic - diagnosis
Renal Insufficiency, Chronic - therapy
Renal Replacement Therapy
Urogenital Abnormalities - diagnosis
Urogenital Abnormalities - therapy
Vesico-Ureteral Reflux - diagnosis
Vesico-Ureteral Reflux - therapy
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Summary:Kidney disease is a global public health concern across the age spectrum, including in children. However, our understanding of the true burden of kidney disease in low-resource areas is often hampered by a lack of disease awareness and access to diagnosis. Chronic kidney disease (CKD) in low-resource settings poses multiple challenges, including late diagnosis, the need for ongoing access to care and the frequent unavailability of costly therapies such as dialysis and transplantation. Moreover, children in such settings are at particular risk of acute kidney injury (AKI) owing to preventable and/or reversible causes - many children likely die from potentially reversible kidney disease because they lack access to appropriate care. Acute peritoneal dialysis (PD) is an important low-cost treatment option. Initiatives, such as the Saving Young Lives programme, to train local medical staff from low-resource areas to provide care for AKI, including acute PD, have already saved hundreds of children. Future priorities include capacity building for both educational purposes and to provide further resources for AKI management. As local knowledge and confidence increase, CKD management strategies should also develop. Increased awareness and advocacy at both the local government and international levels will be required to continue to improve the diagnosis and treatment of AKI and CKD in children worldwide.
ISSN:1759-5061
1759-507X
DOI:10.1038/s41581-020-00338-7