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Transition of Care in Children with Chronic Kidney Disease, Dialysis, and Transplantation

Sandeep Riar1, Tarak Srivastava2,3,4, Roshan George5

  • 1Division of Pediatric Nephrology, Emory University and Children's Healthcare of Atlanta, 2015 Uppergate Drive, Atlanta, GA, 30322, USA. sandeepriar.md@gmail.com.

Indian Journal of Pediatrics
|June 8, 2023
PubMed

Insights

Adolescent and young adult (AYA) patients with pediatric chronic kidney disease (CKD) face unique challenges during transition to adult care. Optimizing this process is crucial for improving treatment adherence and health outcomes.

Area of Science:

  • Nephrology
  • Pediatric Nephrology
  • Adolescent Medicine

Background:

  • Improved survival in pediatric renal disorders increases the number of adolescent and young adult (AYA) patients with chronic kidney disease (CKD) needing transition to adult care.
  • Pediatric CKD presents unique challenges including early onset, different disease spectrum, neurodevelopmental effects, and parental involvement in decision-making.
  • Adolescence and young adulthood are critical periods for AYA patients with CKD, marked by developmental milestones and increased risk of graft failure in transplant recipients.

Purpose of the Study:

  • To discuss the transition process for pediatric CKD patients to adult care settings.
  • To review the challenges faced by AYA patients, families, and healthcare teams during this transition.
  • To provide suggestions and tools for optimizing the transition of pediatric CKD patients.

Main Methods:

  • Review of the transition process for pediatric chronic kidney disease (CKD) patients.
  • Discussion of challenges encountered by patients, families, and healthcare providers.
  • Identification of strategies and tools to facilitate successful transition.

Main Results:

  • Suboptimal transition is linked to poor treatment adherence and adverse health outcomes.
  • Successful transition requires collaboration among patients, families, pediatric and adult nephrology teams, and healthcare systems.
  • Specific challenges include managing a serious medical condition independently during emerging adulthood.

Conclusions:

  • The transition from pediatric to adult care for CKD patients is a complex, longitudinal process.
  • Addressing the unique needs of AYA patients with pediatric CKD is essential for long-term health.
  • Optimizing transition strategies can mitigate risks and improve outcomes for this vulnerable population.

Keywords:
AdolescentsChronic kidney diseaseDialysisNon-adherenceTransferTransitionTransplantYoung adults

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