Survey of legislative frameworks and national recommendations governing paediatric maintenance haemodialysis in Europe.
Publisher DOI
PubMed ID
39847057
Abstract
Background
The application of international recommendations for paediatric maintenance haemodialysis (HD) could be strengthened by national laws or written recommendations. Our aim was therefore to describe the national rules governing paediatric maintenance HD in European countries.Methods
A national representative, approved by the president of each paediatric nephrology society, was contacted in all 42 European countries to complete two online questionnaires.Results
Answers were received from 36 countries. The population served by HD centres varies from 83,000 to 1,197,000 residents below 18 years of age and the estimated mean number of children on HD per centre from 0.2 to 13.5. The lowest age at which a child can be dialysed in an adult centre varies from 0 to 18 years. Laws or written national recommendations specifying: this age, the need for a paediatrician as part of medical team in mixed adult-paediatric centres, the minimum number of doctors per centre and the number of patients per nurse or nurse's aide required during sessions exist in only 25, 22, 22, 44 and 8% of the countries, respectively. Similarly, dietitians, social workers, school service, psychologists and play specialists/youth workers are required by law or written national recommendations in 36, 28, 36, 31 and 14% of countries, respectively.Conclusion
Laws or written national recommendations for paediatric maintenance HD are rare in European countries and very heterogeneous when they exist. This calls for discussion among paediatric and adult nephrologists and health authorities on the organisation of safe and effective paediatric HD practices.
The application of international recommendations for paediatric maintenance haemodialysis (HD) could be strengthened by national laws or written recommendations. Our aim was therefore to describe the national rules governing paediatric maintenance HD in European countries.Methods
A national representative, approved by the president of each paediatric nephrology society, was contacted in all 42 European countries to complete two online questionnaires.Results
Answers were received from 36 countries. The population served by HD centres varies from 83,000 to 1,197,000 residents below 18 years of age and the estimated mean number of children on HD per centre from 0.2 to 13.5. The lowest age at which a child can be dialysed in an adult centre varies from 0 to 18 years. Laws or written national recommendations specifying: this age, the need for a paediatrician as part of medical team in mixed adult-paediatric centres, the minimum number of doctors per centre and the number of patients per nurse or nurse's aide required during sessions exist in only 25, 22, 22, 44 and 8% of the countries, respectively. Similarly, dietitians, social workers, school service, psychologists and play specialists/youth workers are required by law or written national recommendations in 36, 28, 36, 31 and 14% of countries, respectively.Conclusion
Laws or written national recommendations for paediatric maintenance HD are rare in European countries and very heterogeneous when they exist. This calls for discussion among paediatric and adult nephrologists and health authorities on the organisation of safe and effective paediatric HD practices.
Date Issued
2025-06
Publication Type
Article
Subject(s)
Subjects
Child
•
Legal status
•
Maintenance haemodialysis
•
Recommendations
•
Survey
Language(s)
en
Author(s)
Vedrine, Enzo | |
Schmitt, Claus Peter | |
Walle, Johan Vande | |
Shtiza, Diamant | |
Arbeiter, Klaus | |
Snauwaert, Evelien | |
Pokrajac, Danka | |
Roussinov, Dimitar | |
Milosevic, Danko | |
Avraam, Elia | |
Zieg, Jakub | |
Schmidt, Ida Maria | |
Toots, Ylle | |
Holtta, Tuula | |
Klaus, Günter | |
Askiti, Varvara | |
Tory, Kalman | |
Sweeney, Clodagh | |
Verrina, Enrico | |
Jeruma, Edite | |
Jankauskiene, Augustina | |
Conti, Valerie Said | |
Lutovac, Branko | |
Koster-Kamphuis, Linda | |
Tasic, Velibor | |
Bjerre, Anna Kristina | |
Szczepańska, Maria | |
Afonso, Alberto Caldas | |
Rãchişan, Andreea Liana | |
Spasojevic, Brankica | |
Janko, Victor | |
Novljan, Gregor | |
Ortega, Pedro J | |
Sartz, Lisa | |
Bakkaloglu, Sevcan Azime | |
Dudley, Jan | |
Ivanov, Dymtro D | |
Shroff, Rukshana | |
Ranchin, Bruno |
Additional Credits
Journal
Pediatric Nephrology
Publisher
Springer
ISSN
1432-198X
0931-041X
Access(Rights)
open.access