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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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| Published in: | Nature reviews. Nephrology 2021-01, Vol.17 (1), p.33-45 |
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| container_title | Nature reviews. Nephrology |
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| creator | McCulloch, Mignon Luyckx, Valerie A Cullis, Brett Davies, Simon J Finkelstein, Fredric O Yap, Hui Kim Feehally, John Smoyer, William E |
| description | 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. |
| doi_str_mv | 10.1038/s41581-020-00338-7 |
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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.</description><identifier>ISSN: 1759-5061</identifier><identifier>EISSN: 1759-507X</identifier><identifier>DOI: 10.1038/s41581-020-00338-7</identifier><identifier>PMID: 33005036</identifier><language>eng</language><publisher>England: Nature Publishing Group</publisher><subject>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</subject><ispartof>Nature reviews. 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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. 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Nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McCulloch, Mignon</au><au>Luyckx, Valerie A</au><au>Cullis, Brett</au><au>Davies, Simon J</au><au>Finkelstein, Fredric O</au><au>Yap, Hui Kim</au><au>Feehally, John</au><au>Smoyer, William E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Challenges of access to kidney care for children in low-resource settings</atitle><jtitle>Nature reviews. Nephrology</jtitle><addtitle>Nat Rev Nephrol</addtitle><date>2021-01-01</date><risdate>2021</risdate><volume>17</volume><issue>1</issue><spage>33</spage><epage>45</epage><pages>33-45</pages><issn>1759-5061</issn><eissn>1759-507X</eissn><notes>ObjectType-Article-2</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-3</notes><notes>content type line 23</notes><notes>ObjectType-Review-1</notes><abstract>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.</abstract><cop>England</cop><pub>Nature Publishing Group</pub><pmid>33005036</pmid><doi>10.1038/s41581-020-00338-7</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0001-5127-4755</orcidid><orcidid>https://orcid.org/0000-0003-2876-4785</orcidid><orcidid>https://orcid.org/0000-0001-7066-8135</orcidid></addata></record> |
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| 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 |
| title | Challenges of access to kidney care for children in low-resource settings |
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