Global pediatric kidney replacement therapy

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.