title: Inequalities in access to pediatric ESRD care: a global health challenge.
abstract: 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.
authors.affiliation: Unité de Néphrologie Pédiatrique, Service de Pédiatrie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France. jerome.harambat@chu-bordeaux.fr.|Centre INSERM U897-Epidémiologie-Biostatistique, Université de Bordeaux, ISPED, Bordeaux, France. jerome.harambat@chu-bordeaux.fr.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Harambat
authors.affiliation: Unité de Néphrologie Pédiatrique, Service de Pédiatrie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.|Unité de Néphrologie et Hématologie Pédiatrique, Service de Pédiatrie, Centre Hospitalier Universitaire de Kinshasa, Kinshasa, Democratic Republic of Congo.
authors.forename: Pepe Mfutu
authors.initials: PM
authors.lastname: Ekulu
mesh_terms: D002648:Child; D014943:Global Health; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D016030:Kidney Transplantation; D017582:Renal Replacement Therapy; D012959:Socioeconomic Factors
keywords: Children; Chronic kidney disease; Developing countries; End-stage renal disease; Health inequalities