Achievements, priorities and strategies in pediatric nephrology in Europe: need for unifying approaches or acceptance of differences?

BackgroundThere is a lack of information on the current healthcare systems for children with kidney diseases across Europe. The aim of this study was to explore the different national approaches to the organization and delivery of pediatric nephrology services within Europe.MethodsIn 2020, the Europ...

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Main Authors: Jochen Ehrich, Velibor Tasic, Vidar O. Edvardsson, Evgenia Preka, Larisa Prikhodina, Constantinos J. Stefanidis, Rezan Topaloglu, Diamant Shtiza, Ashot Sarkissian, Thomas Mueller-Sacherer, Rena Fataliyeva, Ina Kazyra, Elena Levtchenko, Danka Pokrajac, Dimitar Roussinov, Danko Milošević, Avraam Elia, Tomas Seeman, Mia Faerch, Inga Vainumae, Janne Kataja, Michel Tsimaratos, Irakli Rtskhiladze, Peter F. Hoyer, George Reusz, Atif Awan, Danny Lotan, Licia Peruzzi, Nazym Nigmatullina, Nasira Beishebaeva, Edite Jeruma, Augustina Jankauskiene, Olivier Niel, Valerie Said-Conti, Angela Ciuntu, Snežana Pavićević, Michiel Oosterveld, Anna Bjerre, Marcin Tkaczyk, Ana Teixeira, Adrian C. Lungu, Alexey Tsygin, Vesna Stojanović, Ludmila Podracka, Tanja Kersnik Levart, Mar Espino-Hernández, Per Brandström, Giuseppina Sparta, Harika Alpay, Dmytro Ivanov, Jan Dudley, Komiljon Khamzaev, Dieter Haffner
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Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2024.1458003/full
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author Jochen Ehrich
Velibor Tasic
Vidar O. Edvardsson
Evgenia Preka
Larisa Prikhodina
Constantinos J. Stefanidis
Rezan Topaloglu
Diamant Shtiza
Ashot Sarkissian
Thomas Mueller-Sacherer
Rena Fataliyeva
Ina Kazyra
Elena Levtchenko
Danka Pokrajac
Dimitar Roussinov
Danko Milošević
Avraam Elia
Tomas Seeman
Mia Faerch
Inga Vainumae
Janne Kataja
Michel Tsimaratos
Irakli Rtskhiladze
Peter F. Hoyer
George Reusz
Atif Awan
Danny Lotan
Licia Peruzzi
Nazym Nigmatullina
Nasira Beishebaeva
Edite Jeruma
Augustina Jankauskiene
Olivier Niel
Valerie Said-Conti
Angela Ciuntu
Snežana Pavićević
Michiel Oosterveld
Anna Bjerre
Marcin Tkaczyk
Ana Teixeira
Adrian C. Lungu
Alexey Tsygin
Vesna Stojanović
Ludmila Podracka
Tanja Kersnik Levart
Mar Espino-Hernández
Per Brandström
Giuseppina Sparta
Harika Alpay
Dmytro Ivanov
Jan Dudley
Komiljon Khamzaev
Dieter Haffner
author_facet Jochen Ehrich
Velibor Tasic
Vidar O. Edvardsson
Evgenia Preka
Larisa Prikhodina
Constantinos J. Stefanidis
Rezan Topaloglu
Diamant Shtiza
Ashot Sarkissian
Thomas Mueller-Sacherer
Rena Fataliyeva
Ina Kazyra
Elena Levtchenko
Danka Pokrajac
Dimitar Roussinov
Danko Milošević
Avraam Elia
Tomas Seeman
Mia Faerch
Inga Vainumae
Janne Kataja
Michel Tsimaratos
Irakli Rtskhiladze
Peter F. Hoyer
George Reusz
Atif Awan
Danny Lotan
Licia Peruzzi
Nazym Nigmatullina
Nasira Beishebaeva
Edite Jeruma
Augustina Jankauskiene
Olivier Niel
Valerie Said-Conti
Angela Ciuntu
Snežana Pavićević
Michiel Oosterveld
Anna Bjerre
Marcin Tkaczyk
Ana Teixeira
Adrian C. Lungu
Alexey Tsygin
Vesna Stojanović
Ludmila Podracka
Tanja Kersnik Levart
Mar Espino-Hernández
Per Brandström
Giuseppina Sparta
Harika Alpay
Dmytro Ivanov
Jan Dudley
Komiljon Khamzaev
Dieter Haffner
author_sort Jochen Ehrich
collection DOAJ
description BackgroundThere is a lack of information on the current healthcare systems for children with kidney diseases across Europe. The aim of this study was to explore the different national approaches to the organization and delivery of pediatric nephrology services within Europe.MethodsIn 2020, the European society for Paediatric Nephrology (ESPN) conducted a cross-sectional survey to identify the existing pediatric nephrology healthcare systems in 48 European countries covering a population of more than 200 million children.ResultsThe reported three most important priorities in the care of children with kidney diseases were better training of staff, more incentives for physicians to reduce staff shortages, and more hospital beds. Positive achievements in the field of pediatric nephrology included the establishment of new specialized pediatric nephrology centers, facilities for pediatric dialysis and transplant units in 18, 16, and 12 countries, respectively. The most common problems included no access to any type of dialysis (12), inadequate transplant programs for all ages of children (12), lack of well-trained physicians and dialysis nurses (12), inadequate reimbursement of hospitals for expensive therapies (10), and lack of multidisciplinary care by psychologists, dieticians, physiotherapists, social workers and vocational counsellors (6). Twenty-five of 48 countries (52%) expected to have a shortage of pediatric nephrologists in the year 2025, 63% of clinical nurses and 56% of dialysis nurses. All three groups of health care professionals were expected to be lacking in 38% of countries. Prenatal assessment and postnatal management of renal malformations by a multidisciplinary team including obstetricians, geneticists, pediatricians, and pediatric surgeons was available in one third of countries.ConclusionsOur study shows that there are still very marked differences in pediatric health care systems across the European countries and highlights the need need for appropriate services for children with kidney disease in all European countries.
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spelling doaj-art-952a8a136b03423eae7db72abd1086bf2025-08-20T02:52:13ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602024-12-011210.3389/fped.2024.14580031458003Achievements, priorities and strategies in pediatric nephrology in Europe: need for unifying approaches or acceptance of differences?Jochen Ehrich0Velibor Tasic1Vidar O. Edvardsson2Evgenia Preka3Larisa Prikhodina4Constantinos J. Stefanidis5Rezan Topaloglu6Diamant Shtiza7Ashot Sarkissian8Thomas Mueller-Sacherer9Rena Fataliyeva10Ina Kazyra11Elena Levtchenko12Danka Pokrajac13Dimitar Roussinov14Danko Milošević15Avraam Elia16Tomas Seeman17Mia Faerch18Inga Vainumae19Janne Kataja20Michel Tsimaratos21Irakli Rtskhiladze22Peter F. Hoyer23George Reusz24Atif Awan25Danny Lotan26Licia Peruzzi27Nazym Nigmatullina28Nasira Beishebaeva29Edite Jeruma30Augustina Jankauskiene31Olivier Niel32Valerie Said-Conti33Angela Ciuntu34Snežana Pavićević35Michiel Oosterveld36Anna Bjerre37Marcin Tkaczyk38Ana Teixeira39Adrian C. Lungu40Alexey Tsygin41Vesna Stojanović42Ludmila Podracka43Tanja Kersnik Levart44Mar Espino-Hernández45Per Brandström46Giuseppina Sparta47Harika Alpay48Dmytro Ivanov49Jan Dudley50Komiljon Khamzaev51Dieter Haffner52Department of Pediatric Kidney, Liver, Metabolic and Neurological Diseases, Children’s Hospital, Hannover Medical School, Hannover, GermanyMedical School, University Children’s Hospital, Skopje, North MacedoniaIceland Children’s Medical Center, Faculty of Medicine, School of Health Sciences, Landspitali, The National University Hospital of Iceland, University of Iceland, Reykjavik, IcelandPaediatric Nephrology, University Hospital Southampton NHS Foundation Trust, Southampton, United KingdomResearch and Clinical Institute for Pediatrics, Pirogov Russian National Research Medical University, Moscow, RussiaDivision of Pediatric Nephrology, Mitera Children’s Hospital, Athens, GreeceDepartment of Pediatric Nephrology, Hacettepe University School of Medicine, Ankara, TürkiyeDivision of Pediatric Nephrology, University Hospital Centre “Mother Teresa”, Tirana, AlbaniaArabkir Joint Medical Centre Yerevan, Yerevan State Medical University, Yerevan, Armenia0Department of Pediatric Nephrology and Gastroenterology, Medical University of Vienna, Vienna, Austria1Division of Pediatric Nephrology, Children’s Hospital, Baku, Azerbaijan21st Department of Pediatrics, Belarusian State Medical University, Minsk, Belarus3Department of Pediatrics & Division of Pediatric Nephrology, University Hospitals Leuven, Leuven, Belgium4Division of Pediatric Nephrology, University Children’s Hospital, Sarajevo, Bosnia and Herzegovina5Nephrology and Hemodialysis Clinic, Department of Pediatrics, Medical University of Sofia, Sofia, Bulgaria6Pediatric Clinic, University Hospital Center Zagreb, Zagreb, Croatia7Division of Pediatric Nephrology, Makarios Children Hospital, Nicosia, Cyprus8Department of Pediatrics, 2nd Medical Faculty, Charles University Prague, Prague, Czech Republic9Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark0Department of Pediatrics, University of Tartu, Tartu, Estonia1Department of Paediatrics and Adolescents Medicine, Turku University Hospital, Turku, Finland2Pediatric Nephrology Unit, Department of Multidisciplinary Pediatrics, Assistance Publique des Hôpitaux de Marseille, Marseille, France3Division of Pediatric Nephrology, Medical Centre Mrcheveli, Tbilisi, Georgia4Department of Pediatric Nephrology, University Hospital Essen, Essen, Germany5First Department of Pediatrics, Semmelweis University, Budapest, Hungary6Division of Pediatric Nephrology, Children’s Health Ireland (CHI) at Temple Street, Dublin, Ireland7Division of Pediatric Nephrology, Sheba Medical Center, Edmond and Lily Children’s Hospital, Tel Hashomer, Israel8Division of Pediatric Nephrology, Regina Margherita Children’s Hospital, Torino, Italy9Department of Nephrology, Kazakh National Medical University, Almaty, Kazakhstan0Division of Pediatric Nephrology, Maternity and Child Welfare National Center Under the Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan1Division of Pediatric Nephrology, Bērnuslimībuklīnika, Nefroloģi Jasprofilavirsārste, Riga, Latvia2Pediatric Center, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania3Pediatric Nephrology, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg4Department of Child and Adolescent Health, Mater Dei Hospital, Msida, Malta5Nephrology Unit, National Institute of Health Care for Mother and Child, Chisinau, Moldova6Clinical Center of Montenegro, Institute for Sick Children, Podgorica, Montenegro7Department of Paediatric Nephrology, Emma Children’s Hospital Amsterdam University Medical Center, Amsterdam, Netherlands8Department of Pediatric and Adolescent Medicine, University Hospital of Oslo, Oslo, Norway9Department of Pediatrics, Immunology and Nephrology, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland0Pediatric Nephrology Division, Centro Hospitalar Universitário do Porto, Porto, Portugal1Pediatric Nephrology, Fundeni Clincal Institute, Bucharest, Romania2Division of Pediatric Nephrology, Institute of Pediatrics NCZD, Moscow, Russia3Division of Pediatric Nephrology, Institute for Child and Youth Health Care of Vojvodina Novi Sad, Novi Sad, Serbia4Department of Pediatrics, Comenius University, Bratislava, Slovakia5Pediatric Nephrology Department, Children’s Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia6Pediatric Nephrology, Pediatrics, University Hospital 12 Octubre, Madrid, Spain7Pediatric Uro-Nephrologic Center, Department of Pediatrics, Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden8Department of Pediatric Nephrology, University Children’s Hospital, Zurich, Switzerland9Division of Pediatric Nephrology, Marmara University, Istanbul, Türkiye0Nephrology and RRT Department, Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine1Division of Pediatric Nephrology, Bristol Royal Hospital for Children, Bristol, United Kingdom2Division of Pediatric Nephrology, Pediatric Medical Institute, Tashkent, UzbekistanDepartment of Pediatric Kidney, Liver, Metabolic and Neurological Diseases, Children’s Hospital, Hannover Medical School, Hannover, GermanyBackgroundThere is a lack of information on the current healthcare systems for children with kidney diseases across Europe. The aim of this study was to explore the different national approaches to the organization and delivery of pediatric nephrology services within Europe.MethodsIn 2020, the European society for Paediatric Nephrology (ESPN) conducted a cross-sectional survey to identify the existing pediatric nephrology healthcare systems in 48 European countries covering a population of more than 200 million children.ResultsThe reported three most important priorities in the care of children with kidney diseases were better training of staff, more incentives for physicians to reduce staff shortages, and more hospital beds. Positive achievements in the field of pediatric nephrology included the establishment of new specialized pediatric nephrology centers, facilities for pediatric dialysis and transplant units in 18, 16, and 12 countries, respectively. The most common problems included no access to any type of dialysis (12), inadequate transplant programs for all ages of children (12), lack of well-trained physicians and dialysis nurses (12), inadequate reimbursement of hospitals for expensive therapies (10), and lack of multidisciplinary care by psychologists, dieticians, physiotherapists, social workers and vocational counsellors (6). Twenty-five of 48 countries (52%) expected to have a shortage of pediatric nephrologists in the year 2025, 63% of clinical nurses and 56% of dialysis nurses. All three groups of health care professionals were expected to be lacking in 38% of countries. Prenatal assessment and postnatal management of renal malformations by a multidisciplinary team including obstetricians, geneticists, pediatricians, and pediatric surgeons was available in one third of countries.ConclusionsOur study shows that there are still very marked differences in pediatric health care systems across the European countries and highlights the need need for appropriate services for children with kidney disease in all European countries.https://www.frontiersin.org/articles/10.3389/fped.2024.1458003/fullEuropean child healthcare servicesnephrologyachievementsneedsworkforceprevention
spellingShingle Jochen Ehrich
Velibor Tasic
Vidar O. Edvardsson
Evgenia Preka
Larisa Prikhodina
Constantinos J. Stefanidis
Rezan Topaloglu
Diamant Shtiza
Ashot Sarkissian
Thomas Mueller-Sacherer
Rena Fataliyeva
Ina Kazyra
Elena Levtchenko
Danka Pokrajac
Dimitar Roussinov
Danko Milošević
Avraam Elia
Tomas Seeman
Mia Faerch
Inga Vainumae
Janne Kataja
Michel Tsimaratos
Irakli Rtskhiladze
Peter F. Hoyer
George Reusz
Atif Awan
Danny Lotan
Licia Peruzzi
Nazym Nigmatullina
Nasira Beishebaeva
Edite Jeruma
Augustina Jankauskiene
Olivier Niel
Valerie Said-Conti
Angela Ciuntu
Snežana Pavićević
Michiel Oosterveld
Anna Bjerre
Marcin Tkaczyk
Ana Teixeira
Adrian C. Lungu
Alexey Tsygin
Vesna Stojanović
Ludmila Podracka
Tanja Kersnik Levart
Mar Espino-Hernández
Per Brandström
Giuseppina Sparta
Harika Alpay
Dmytro Ivanov
Jan Dudley
Komiljon Khamzaev
Dieter Haffner
Achievements, priorities and strategies in pediatric nephrology in Europe: need for unifying approaches or acceptance of differences?
Frontiers in Pediatrics
European child healthcare services
nephrology
achievements
needs
workforce
prevention
title Achievements, priorities and strategies in pediatric nephrology in Europe: need for unifying approaches or acceptance of differences?
title_full Achievements, priorities and strategies in pediatric nephrology in Europe: need for unifying approaches or acceptance of differences?
title_fullStr Achievements, priorities and strategies in pediatric nephrology in Europe: need for unifying approaches or acceptance of differences?
title_full_unstemmed Achievements, priorities and strategies in pediatric nephrology in Europe: need for unifying approaches or acceptance of differences?
title_short Achievements, priorities and strategies in pediatric nephrology in Europe: need for unifying approaches or acceptance of differences?
title_sort achievements priorities and strategies in pediatric nephrology in europe need for unifying approaches or acceptance of differences
topic European child healthcare services
nephrology
achievements
needs
workforce
prevention
url https://www.frontiersin.org/articles/10.3389/fped.2024.1458003/full
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