Pediatric Kidney Care in Northern Central America: A Survey of Pediatric Nephrologists

Area of Science:

• Public Health
• Nephrology
• Pediatrics

Background:

• Chronic kidney disease (CKD) is a significant global health issue.
• Northern Central American countries exhibit high CKD-related mortality and years of life lost.
• A systematic documentation of pediatric kidney care gaps in this region was lacking.

Purpose of the Study:

• To systematically document the epidemiology and current status of pediatric kidney care programs in Northern Central America.
• To identify challenges and opportunities for improving pediatric kidney care in Guatemala, El Salvador, Honduras, and Nicaragua.

Main Methods:

• A survey was distributed to directors of pediatric kidney care referral centers in Guatemala, El Salvador, Honduras, and Nicaragua.
• Data collected included population demographics, incidence and prevalence of pediatric kidney failure (pKF), types of kidney replacement therapy (KRT), transplantation rates, and availability of pediatric nephrologists.

Main Results:

• The region's population is 40.4 million, with 17 million under 21.
• Median incidence of pKF was 8.4 per million age-related population (pmarp), and median prevalence was 34 pmarp.
• Continuous ambulatory peritoneal dialysis (CAPD) was the primary KRT; hemodialysis (HD) was used in 26.5%, and 0.9 transplants pmarp were performed. Pediatric nephrologist rates ranged from 1.5 to 2.3 pmarp.

Conclusions:

• Significant disparities exist in pediatric kidney care across Northern Central America.
• The findings highlight the need for a multinational plan for prevention, management, and resource allocation.
• Collaboration with national and international initiatives is crucial for enhancing pediatric kidney care services.