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Paediatric nephrology in under-resourced areas

Sushmita Banerjee1, Nivedita Kamath2, Sampson Antwi3

  • 1Calcutta Medical Research Institute, Kolkata, India. sushmitabanerj@gmail.com.

Pediatric Nephrology (Berlin, Germany)
|April 11, 2021
PubMed

Insights

Paediatric nephrology (PN) services in under-resourced areas face significant challenges due to limited health resources and data scarcity. Despite these hurdles, regional efforts and international support are improving PN care for children globally.

Area of Science:

  • Global Health
  • Pediatric Nephrology
  • Resource Allocation

Background:

  • Nearly half the world's population, including 60% of children, resides in low- or lower-middle-income countries.
  • Pediatric nephrology (PN) is often deprioritized in health resource allocation within these regions.
  • This article examines progress and ongoing limitations in delivering optimal PN services in under-resourced areas (URA).

Purpose of the Study:

  • To explore advancements and persistent limitations in pediatric nephrology (PN) services for children in under-resourced areas (URA).
  • To identify key challenges and progress in global pediatric kidney care.

Main Methods:

  • Searched Medline, PubMed, and Google Scholar for PN disease epidemiology, outcomes, and service availability in URA.
  • Contacted International Society of Nephrology (ISN) and International Pediatric Nephrology Association (IPNA) offices for data.
  • Conducted two online IPNA membership surveys and contacted regional IPNA members for detailed information.

Main Results:

  • Scarcity of published data from URA, with reported PN disease prevalence, management, and outcomes differing from high-income regions.
  • Identified deficiencies in human resources and advanced diagnostic tools (fluoroscopy, imaging, microscopy, genetic studies).
  • Many essential drugs and kidney replacement therapies are inaccessible; however, regional initiatives and international support have advanced PN services and infrastructure.

Conclusions:

  • Equitable distribution and affordability of PN services remain critical challenges in URA.
  • Continued efforts in regional data collection, advocacy, and international partnerships are essential.
  • The goal is to optimize PN training, investigations, and treatments, aiming for global parity, focusing initially on preventable conditions.
Abstract

Keywords:
Kidney replacement therapyLow-income countryLow-middle–income countryPaediatric nephrologyUnder-resourced

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