Transition from pediatric to adult renal services: a consensus statement by the International Society of Nephrology (ISN) and the International Pediatric Nephrology Association (IPNA)

Abstract

The transfer of young patients from pediatric to adult renal care takes place after a transition process which involves both sides. It is important that it is individualized for each young person, focusing on self-management skills as well as assessing support structures. The consensus statement has been developed by the panel of adult and pediatric nephrologists and endorsed by the councils of both ISN and IPNA. It is hoped that the statement will provide a basis for the development of locally appropriate recommendations for clinical practice.

Psychosocial support for children and families requiring renal replacement therapy

“…The success of paediatric RRT means that there is an increasing number of patients needing preparation for transition and subsequent transfer from paediatric to adult units [56,57]. However, before reaching the age when transfer is appropriate young people have to negotiate their way through adolescence, which brings additional psychosocial concerns with reported levels of very poor adherence [58].…”

How to grow up with chronic kidney disease?

“…The International Society of Nephrology and the International Pediatric Nephrology Association in 2011 have jointly drawn up a document with the main guidelines for organization of the transition, and the responsibility for performing this process is shared between the pediatric and adult nephrologists (8). This document emphasizes the need for the transition program from the pediatric to the adult institution to be individualized for each patient, taking into account the level of physical and mental development achieved, and also the goals achieved in education, social and psychosocial development, as well as the structure of possible support (8).…”

“…This document emphasizes the need for the transition program from the pediatric to the adult institution to be individualized for each patient, taking into account the level of physical and mental development achieved, and also the goals achieved in education, social and psychosocial development, as well as the structure of possible support (8). Increasing education and awareness about renal diseases in general, and kidney disease in childhood in particular are obligatory measures for both patients and their caregivers, from their very first meeting with pediatric nephrologists.…”

“…However, in the present day children with well-managed ESRD, thanks to comprehensive multidisciplinary pediatric treatment, have much better quality of life and look well, often not different from their healthy peers. Nevertheless, the transition of an adolescent patient from pediatric to adult nephrologists is still a major problem with possible negative consequences because of the disruption of continuity in the earlier pediatric treatment (5)(6)(7)(8)(9). The problem of transition deserves a great deal of attention.…”

Día Mundial del Riñón 2016. Prevención del legado de la nefropatía, con enfoque en la niñez

“…En una reciente declaración de consenso conjunta de la ISN y la IPNA, se propusieron medidas coincidentes con los puntos aquí delineados, que apuntan a mejorar la transición de la atención de las nefropatías en la práctica clínica. 29,30 Llamamiento a generar más información y a la acción Dadas las vulnerabilidades de los niños con nefropatía, incluido el impacto sobre el crecimiento y el desarrollo y su vida futura como adultos, y debido a la mayor proporción de niños en los países en vías de desarrollo que enfrentan limitaciones de recursos, la educación de todas las personas involucradas es esencial para realinear las comunicaciones y las acciones. 31,32 Estos esfuerzos deberían fomentar el desarrollo de colaboraciones regionales e internacionales y el intercambio de ideas entre las fundaciones nefrológicas, las sociedades profesionales y otras organizaciones sin fines de lucro locales, y los estados y los gobiernos, para ayudar a empoderar a todas las partes interesadas a mejorar la salud, el bienestar y la calidad de vida de los niños con nefropatía y para garantizarles una vida adulta longeva.…”