Challenges Facing Children on Chronic Peritoneal Dialysis in South Africa

Levy, Cecil; Mudi, Abdullahi; Venter, Bonnie; Geel, Jennifer

doi:10.3747/pdi.2017.00275

Cited by 9 publications

(4 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When families are unable to meet costs, they reduce the number of PD cycles or days on HD. Due to routine under-dialysis, children have higher rates of infectious complications, more morbidity and poorer quality of life (QoL) compared to their HIC counterparts ( 65 , 66 ). Death or discontinuation of treatment occurs in 50–80% of children ( 29 , 67 ).…”

Section: Inequity In Dialysis Experience and Outcomesmentioning

confidence: 99%

“…Denial of access to medical treatment based on ability to pay raises serious concerns of justice. In the setting of unavoidable resource shortage it is necessary to develop clear, explicit procedures for considering decision-making for every child ( 65 , 116 , 117 ). These procedures must be country or region specific, informed by relevant evidence and ethical principles and take into account available resources and social supports.…”

Section: Suggested Action-points For Resolving Ethical Challenges In ...mentioning

confidence: 99%

See 1 more Smart Citation

Addressing the Ethical Challenges of Providing Kidney Failure Care for Children: A Global Stance

Pais

Wightman

2022

Front. Pediatr.

View full text Add to dashboard Cite

Children with kidney failure require kidney replacement therapy (KRT), namely maintenance dialysis and kidney transplant. Adequate kidney failure care consists of KRT or conservative treatment with palliative care. In the context of kidney failure, children depend on parents who are their surrogate decision-makers, and the pediatric nephrology team for taking decisions about KRT or conservative care. In this paper, we discuss the ethical challenges that arise relating to such decision-making, from a global perspective, using the framework of pediatric bioethics. While many ethical dilemmas in the care of children with KRT are universal, the most significant ethical dilemma is the inequitable access to KRT in low & middle income countries (LMICs) where rates of morbidity and mortality depend on the family's ability to pay. Children with kidney failure in LMICs have inadequate access to maintenance dialysis, timely kidney transplant and palliative care compared to their counterparts in high income countries. Using case vignettes, we highlight how these disparities place severe burdens on caregivers, resulting in difficult decision-making, and lead to moral distress among pediatric nephrologists. We conclude with key action points to change this status-quo, the most important being advocacy by the global pediatric nephrology community for better access to affordable kidney failure care for children.

show abstract

Section: Inequity In Dialysis Experience and Outcomesmentioning

confidence: 99%

Section: Suggested Action-points For Resolving Ethical Challenges In ...mentioning

confidence: 99%

Addressing the Ethical Challenges of Providing Kidney Failure Care for Children: A Global Stance

Pais

Wightman

2022

Front. Pediatr.

View full text Add to dashboard Cite

show abstract

“…The discussion should quantify the expected quality of life and prognosis of the child, and address the expected quality of life for the family ( 32 , 33 ). The physical, psychological, and social burden on the caregivers of children on cKRT is well-documented and the family social situation, distance, and means of transport from the dialysis center and reliability of electricity supply must all be considered ( 34 ).…”

Section: Ethical Issues Around the Provision Of Chronic Kidney Replac...mentioning

confidence: 99%

Perspectives: Neonatal acute kidney injury (AKI) in low and middle income countries (LMIC)

et al. 2022

View full text Add to dashboard Cite

Neonatal AKI (NAKI) remains a challenge in low- and middle-income countries (LMICs). In this perspective, we address issues of diagnosis and risk factors particular to less well-resourced regions. The conservative management pre-kidney replacement therapy (pre-KRT) is prioritized and challenges of KRT are described with improvised dialysis techniques also included. Special emphasis is placed on ethical and palliation principles.

show abstract

“…Children often are denied dialysis and transplantation because of a lack of social support. 67 For patients, the waiting period between diagnosis of ESKD and final decisions about acceptance or not into the chronic dialysis program is highly distressing. 68 Patients can appeal a decision against dialysis in a race against time, most often appealing to their human right to health, but these appeals are rarely successful.…”

Section: Priority Setting At the Bedside: Rationing Of Kidney Carementioning

confidence: 99%

Priority Setting as an Ethical Imperative in Managing Global Dialysis Access and Improving Kidney Care

Luyckx

Moosa

2021

Seminars in Nephrology

View full text Add to dashboard Cite

Challenges Facing Children on Chronic Peritoneal Dialysis in South Africa

Cited by 9 publications

References 27 publications

Addressing the Ethical Challenges of Providing Kidney Failure Care for Children: A Global Stance

Addressing the Ethical Challenges of Providing Kidney Failure Care for Children: A Global Stance

Perspectives: Neonatal acute kidney injury (AKI) in low and middle income countries (LMIC)

Priority Setting as an Ethical Imperative in Managing Global Dialysis Access and Improving Kidney Care

Contact Info

Product

Resources

About