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Pediatr Nephrol. 2019 Oct 29. doi: 10.1007/s00467-019-04378-5. [Epub ahead of print]

The European Society for Paediatric Nephrology study of pediatric renal care in Europe: comparative analysis 1998-2017.

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Research and Clinical Institute for Pediatrics, Pirogov Russian National Research Medical University, Taldomskaya St., 2, Moscow, Russia, 125412.
Children's Hospital, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
Great Ormond Street Hospital for Children NHS Foundation Trust, WC1N 3JH, London, UK.
Hacettepe University, Hacettepe Mh, 06230, Ankara, Turkey.
University Hospitals Leuven & KU Leuven, Oude Markt 13, 3000, Leuven, Belgium.



In 1998, a survey of the European Society for Paediatric Nephrology (ESPN) revealed substantial disparities in pediatric renal care among European countries. Therefore, ESPN aimed at harmonizing renal care in all European countries in the following 20 years. In 2017, we conducted a survey to evaluate the current status of renal health policies for children in Europe.


A 33-question web-based survey was designed and sent to presidents or representatives of national societies of pediatric nephrology in 44 European countries.


Data was reported from 42 (95.5%) countries. The number of pediatric nephrologists per million child population increased from 1998 to 2017 in 70% of countries. Pediatric dialysis facilities for acute kidney injury and end-stage kidney disease were available in 95% of countries. The availability of pediatric kidney transplantation increased from 55 to 93% of countries. Considerable variation was found in the current availability of allied health professionals, including psychosocial and nutritional support, high-tech diagnostic methods, and treatment with expensive drugs for children with kidney diseases between different European countries.


The 20-year follow-up analysis of pediatric renal care services in European countries revealed that pediatric nephrology has become a well-established subspecialty in pediatrics and nephrology in 2017. The ESPN will continue its efforts to further improve pediatric renal care for European children by harmonizing remaining disparities of renal care services.


Demography; Europe; Health policy; Pediatric nephrology; Pediatric renal care services


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