Inequalities in access to pediatric ESRD care: a global health challenge

Jérôme Harambat1,2 & Pepe Mfutu Ekulu1,3

Received: 28 October 2015 /Accepted: 2 November 2015
# IPNA 2015

Abstract The increasing attention paid to chronic kidney disease (CKD) as a major cause of mortality and disability, as well as the advances inmanagement of CKD in children, have created a growing demand for pediatric renal replacement therapy (RRT) worldwide. A study by Koch Nogueira and colleagues of children on the transplant waiting list showed large disparities in access to pediatric kidney transplantation
between regions in Brazil. This finding raises a wider question about inequalities in access to CKD care in children. Here we review the available data on the global burden of end-stage renal disease in children, the need for pediatric RRT, and its actual provision worldwide. We focus on inequalities in access to renal care for children that currently exist between and within countries. Reduction in worldwide inequalities in access to RRT in children remains a challenge, which requires greater awareness and effective interventions and policies.

Keywords End-stage renal disease . Chronic kidney disease .
Children . Health inequalities . Developing countries

* Jérôme Harambat
jerome.harambat@chu-bordeaux.fr
1 Unité de Néphrologie Pédiatrique, Service de Pédiatrie, Centre
Hospitalier Universitaire de Bordeaux, Bordeaux, France
2 Centre INSERM U897-Epidémiologie-Biostatistique, Université de
Bordeaux, ISPED, Bordeaux, France
3 Unité de Néphrologie et Hématologie Pédiatrique, Service de
Pédiatrie, Centre Hospitalier Universitaire de Kinshasa,
Kinshasa, Democratic Republic of Congo