Harambat Jérôme, Ekulu Pepe Mfutu
Unité de Néphrologie Pédiatrique, Service de Pédiatrie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
Centre INSERM U897-Epidémiologie-Biostatistique, Université de Bordeaux, ISPED, Bordeaux, France.
Pediatr Nephrol. 2016 Mar;31(3):353-8. doi: 10.1007/s00467-015-3263-7. Epub 2015 Dec 1.
The increasing attention paid to chronic kidney disease (CKD) as a major cause of mortality and disability, as well as the advances in management 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.
慢性肾脏病（CKD）作为导致死亡和残疾的主要原因，日益受到关注，同时儿童CKD管理方面的进展也使得全球对儿童肾替代治疗（RRT）的需求不断增加。科赫·诺盖拉及其同事对等待移植的儿童进行的一项研究表明，巴西各地区在获得儿童肾移植方面存在巨大差异。这一发现引发了一个更广泛的问题，即儿童获得CKD治疗方面的不平等。在此，我们回顾了关于儿童终末期肾病全球负担、儿童RRT需求及其在全球实际提供情况的现有数据。我们关注目前国家之间和国家内部在儿童获得肾脏护理方面存在的不平等。减少全球范围内儿童获得RRT的不平等仍然是一项挑战，这需要提高认识以及采取有效的干预措施和政策。
