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Updated: Aug 15, 2026
Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
Global pediatric kidney replacement therapy
Rummana Tazia Tonny1, Md Mostafa Kamal1, Shajjad Hossan1
1Department of Pediatric Nephrology, Bangladesh Medical University, Dhaka, Bangladesh.
Insights
Pediatric end-stage kidney disease (ESKD) is a growing global concern. Equitable access to kidney replacement therapy (KRT) is crucial, as disparities persist between high-resource and low-resource settings, impacting child mortality.
Area of Science:
- Pediatric Nephrology
- Global Health
- Renal Medicine
Background:
- Chronic kidney disease (CKD) significantly impacts child morbidity and mortality globally.
- Pediatric end-stage kidney disease (ESKD) necessitates kidney replacement therapy (KRT), but access is inequitable worldwide.
Purpose of the Study:
- To review the current knowledge on pediatric ESKD burden, treatments, and care barriers.
- To highlight disparities in KRT access between high-resource and low-resource settings.
Main Methods:
- Focused review of existing literature and global registry data.
- Data extracted from Google Scholar and PubMed.
Main Results:
- Glomerulonephritis and congenital anomalies of the kidney and urinary tract (CAKUT) are leading causes of pediatric ESKD.
- Children in high-income countries receive most KRT, while low- and middle-income countries face critical resource shortages.
- Mortality is significantly higher in children without appropriate KRT, emphasizing the need to address disparities.
Conclusions:
- Coordinated global action is essential to improve early detection and reinforce health systems for pediatric ESKD.
- Expanding equitable access to KRT, especially in low-resource settings, is critical to reduce the burden of pediatric ESKD.
Introduction:
Chronic kidney disease (CKD) is an important and growing global health concern in children, contributing substantially to morbidity and mortality. Pediatric end-stage kidney disease (ESKD) requires kidney replacement therapy (KRT) in the form of hemodialysis, peritoneal dialysis, or transplantation, yet access remains highly inequitable worldwide.
Materials And Methods:
This review focuses on current knowledge regarding the burden of pediatric ESKD, available treatment options, and barriers to renal care, with particular attention to differences between high-resource and low-resource settings. Relevant updated DATA were extracted from the Google Scholar, PubMed databases, global registries.
Results:
Glomerulonephritis and congenital anomalies of the kidney and urinary tract (CAKUT) are among the leading causes of ESKD in children, with regional variation influenced by environmental, infectious, and genetic factors. Despite substantial advances in KRT, children living in high-income and upper-middle-income countries account for most of those receiving treatment, while low- and middle-income countries face critical shortages of resources, infrastructure, and trained professionals. Mortality among children who do not receive appropriate therapy remains markedly higher than in the general pediatric population, underscoring the urgency of addressing these disparities. This review also outlines key mitigation strategies, including context-appropriate, cost-effective dialysis models, workforce development, and international efforts to strengthen pediatric kidney care.
Conclusion:
Addressing the burden of pediatric ESKD will require coordinated action to improve early detection, reinforce health systems, and expand equitable access to KRT globally, particularly in low-resource settings.
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