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45 References 1 Chesney RW The development of pediatric nephrol ogy Pediatr Res 2002;52(5) 770–8 2 Rees L, et al Chronic dialysis in children and ado lescents challenges and outcomes Lancet Child Adol[.]

3  The Demographics of Dialysis in Children References Chesney RW. The development of pediatric nephrology Pediatr Res 2002;52(5):770–8 Rees L, et  al Chronic dialysis in children and adolescents: challenges and outcomes Lancet Child Adolesc Health 2017;1(1):68–77 Sanderson KR, Warady BA. End-stage kidney disease in infancy: an educational review Pediatr Nephrol 2018;35(2):229–40 Fadrowski JJ, et al Patterns of use of vascular catheters for hemodialysis in children in the United States Am J Kidney Dis 2009;53(1):91–8 North american pediatric renal trials and collaborative studies (NAPRTCS) 2011 annual report Online at: https://web.emmes.com/study/ped/annlrept/annualrept2011.pdf Accessed 15 Dec 2018 Weaver DJ Jr, et  al Clinical outcomes and survival in pediatric patients initiating chronic dialysis: a report of the NAPRTCS registry Pediatr Nephrol 2017;32(12):2319–30 van Amstel SP, et  al Renal replacement therapy for children throughout the world: the need for a global registry Pediatr Nephrol 2018;33(5):863–71 Hamilton AJ, et  al UK renal registry 19th annual report: chapter demography of the UK paediatric renal replacement therapy population in 2015 Nephron 2017;137(Suppl 1):103–16 North american pediatric renal trials and collaborative studies (NAPRTCS) annual reports Online at: https:// web.emmes.com/study/ped/annlrept/annlrept.html Accessed Dec 2018 10 ESPN/ERA-EDTA registry european registry for children on renal replacement therapy Links to national and regional registries collecting paediatric data Online at: https://www.espn-reg.org/index jsp?p=lnk Accessed Dec 2018 11 Grunberg J, et  al Twenty years’ pediatric chronic peritoneal dialysis in Uruguay: patient and technique survival Pediatr Nephrol 2005;20(9):1315–9 12 Ferris M, et  al Hemodialysis outcomes in a global sample of children and young adult hemodialysis patients: the PICCOLO MONDO cohort Clin Kidney J 2016;9(2):295–302 13 Konstantyner T, et  al Pediatric chronic Dialysis in Brazil: epidemiology and regional inequalities PLoS One 2015;10(8):e0135649 14 North american pediatric renal trials and collaborative studies (NAPRTCS) 2014 Annual transplant report Online at: https://web.emmes.com/study/ped/annlrept/annualrept2014.pdf Accessed Dec 2018 15 U.S.  Renal Data System, USRDS 2018 annual data report: Epidemiology of kidney disease in the United States National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 2018 Online at: https://www.usrds org/adr.aspx Accessed Dec 2018 16 Harambat J, et  al Epidemiology of chronic kidney disease in children Pediatr Nephrol 2012;27(3):363–73 45 17 Harambat J, Ekulu PM. Inequalities in access to pediatric ESRD care: a global health challenge Pediatr Nephrol 2016;31(3):353–8 18 Ashuntantang G, et al Outcomes in adults and children with end-stage kidney disease requiring dialysis in sub-Saharan Africa: a systematic review Lancet Glob Health 2017;5(4):e408–17 19 Schaefer F, et al Impact of global economic disparities on practices and outcomes of chronic peritoneal dialysis in children: insights from the International Pediatric Peritoneal Dialysis Network Registry Perit Dial Int 2012;32(4):399–409 20 Chesnaye NC, et  al Disparities in treatment rates of paediatric end-stage renal disease across Europe: insights from the ESPN/ERA-EDTA registry Nephrol Dial Transplant 2015;30(8):1377–85 21 Ng DK, et al Racial differences in renal replacement therapy initiation among children with a nonglomerular cause of chronic kidney disease Ann Epidemiol 2016;26(11):780–7, e1 22 Ku E, et  al Racial and ethnic disparities in sur vival of children with ESRD.  J Am Soc Nephrol 2017;28(5):1584–91 23 Hidalgo G, et  al Association of income level with kidney disease severity and progression among ­children and adolescents with CKD: a report from the Chronic Kidney Disease in Children (CKiD) Study Am J Kidney Dis 2013;62(6):1087–94 24 ANZDATA Registry 37th report, chapter 11: Paediatrics Australia and New Zealand dialysis and transplant registry, Adelaide, Australia 2015 Available at: http://www.anzdata.org.au 25 Hari P, et al Chronic renal failure in children Indian Pediatr 2003;40(11):1035–42 26 Lagomarsimo E, et  al Chronic renal failure in pediatrics 1996 Chilean survey Pediatr Nephrol 1999;13(4):288–91 27 Al-Eisa AA, Samhan M, Naseef M. End-stage renal disease in Kuwaiti children: an 8-year experience Transplant Proc 2004;36(6):1788–91 28 Verrina E, et al A multicenter experience on patient and technique survival in children on chronic dialysis Pediatr Nephrol 2004;19(1):82–90 29 Anochie I, Eke F.  Chronic renal failure in children: a report from Port Harcourt, Nigeria (1985-2000) Pediatr Nephrol 2003;18(7):692–5 30 Hattori S, et  al The 1998 report of the Japanese National Registry data on pediatric end-stage renal disease patients Pediatr Nephrol 2002;17(6):456–61 31 Hattori M. Current trend of pediatric renal replacement therapy in Japan Contrib Nephrol 2018;196:223–8 32 The renal association UK renal registry The fifth annual report December 2002 Online at: https:// www.renalreg.org/reports/2002-the-fifth-annualreport/ Accessed 15 Dec 2018 33 Chesnaye NC, et al Mortality risk in European children with end-stage renal disease on dialysis Kidney Int 2016;89(6):1355–62 34 Sanderson KR, et  al Outcomes of infants receiving chronic peritoneal dialysis: an analysis of the USRDS registry Pediatr Nephrol 2018;34(1):155–62 46 35 Hooman N, et al The outcome of Iranian children on continuous ambulatory peritoneal dialysis: the first report of Iranian National Registry Arch Iran Med 2009;12(1):24–8 36 Tsai TC, et al Incidence and renal survival of ESRD in the young Taiwanese population Clin J Am Soc Nephrol 2014;9(2):302–9 37 Chang HJ, et  al Outcomes of chronic dialysis in Korean children with respect to survival rates and causes of death Korean J Pediatr 2014;57(3):135–9 38 Samuel SM, et  al Survival in pediatric dialysis and transplant patients Clin J Am Soc Nephrol 2011;6(5):1094–9 J J Fadrowski and L Rees 39 Mong Hiep TT, et al Etiology and outcome of chronic renal failure in hospitalized children in Ho Chi Minh City, Vietnam Pediatr Nephrol 2008;23(6):965–70 40 Sumboonnanonda A, et  al Chronic renal failure in Thai children: etiology, cost, and outcome J Med Assoc Thail 2000;83(8):894–901 41 Gulati S, et  al Etiology and outcome of chronic renal failure in Indian children Pediatr Nephrol 1999;13(7):594–6 42 El-Reshaid K, et al Pediatric dialysis and renal transplantation in Kuwait over the past 11 years Pediatr Nephrol 1999;13(3):259–64 4 Chronic Dialysis in Developing Countries Hui-Kim Yap and Francisco Cano Introduction Worldwide, the number of end stage renal disease (ESRD) patients has been rapidly increasing, with more than a million patients receiving dialysis therapy Coverage of renal replacement therapy (RRT) is usually directly related to country-­specific gross national income (GNI) In pediatrics, global data from the International Pediatric Peritoneal Dialysis Network (IPPN) showed that dialysis patient survival was associated with GNI status, being significantly higher in high-income economies (94.1% at 5  years), compared to middle- and low-income countries combined (88.7%) The provision of RRT, funding, dialysis modality, ESRD etiology, technical resources and trained healthcare professionals also show important variation across regions around the world, most of the cases directly related to economic and cultural factors The IPPN data also showed that these differences have an impact on growth, nutrition, biochemical status and dialysis-related complications such as peritonitis, especially in children with chronic kidney disease in the developing world This chapter provides an analysis of the differences in H.-K Yap Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore F Cano (*) Luis Calvo Mackenna Children’s Hospital, University of Chile, Pediatric Nephrology, Santiago, Chile RRT around the world, allowing a better understanding of the ways to improve dialysis programs for children and adolescents in developing regions Economic Indicators Since more than 30  years ago, chronic dialysis has become the cornerstone of the treatment for patients with end-stage renal disease (ESRD) However, access to dialysis is limited in several regions of the world due to a lack of financial resources and technical development [1] The coverage of renal replacement therapy (RRT) is far from being uniform around the world, and usually is directly related to country-specific gross national income (GNI) According to the World Bank (WB) 2019 data [2], countries/economies are classified into income groups, low, lower-middle, upper-middle, and high-income countries Low-income economies are defined as those with a GNI per capita of US$ 995 or less; lower-middle-income economies are those with a GNI per capita between US$ 996 and 3895; upper-middle-income economies are those with a GNI per capita between US$ 3896 and 12,055, and high-income economies are those with a GNI per capita of US$12,056 or more Of note, the developing world which includes the lowincome and lower-middle-income economies is estimated to account for 80% of the global population © Springer Nature Switzerland AG 2021 B A Warady et al (eds.), Pediatric Dialysis, https://doi.org/10.1007/978-3-030-66861-7_4 47 48 Epidemiology of Renal Replacement Therapy in Developing Countries Worldwide, the number of ESRD patients has been rapidly increasing A decade ago, more than 1 million patients were reported to receive dialysis therapy, with an annual estimated growth rate of 7% [3, 4] Among the main factors associated with this growth are the longer life expectancy, an increasing survival rate of ESRD patients, and a growing access of younger patients to RRT therapies in developing countries, where the access has been previously limited A large survey sharing a global dialysis company program representing more than 90% of the global population, and which included 122 countries with a wide range of socioeconomic levels, was published more than a decade ago [3] The prevalence ESRD values per million population (pmp) showed important differences between regions The high-income regions, North America (1505 ESRD patients pmp/1030 on dialysis pmp), Europe (585/400  pmp), and Japan (2045/1945  pmp), showed a higher prevalence rate for ESRD and dialyzed patients, compared to Latin America (380/320 pmp), Middle East (190/140 pmp), and Asia and Africa (70/70  pmp), respectively The prevalence dialysis data showed that 52% of the global dialysis population was located in four countries, namely, the United States of America, Japan, Germany, and Brazil, with the first three belonging to the high-income WB classification However, these countries accounted for only around 11% of the world population Given that the survey included mostly adult data, hemodialysis (HD) was the most common RRT modality The prevalence values for HD vs peritoneal dialysis (PD) therapy showed higher rates in Japan (1865/80  pmp), North America (940/95  pmp), and Europe (360/40  pmp), followed by Latin America (240/75  pmp), Middle East (130/10 pmp), and Africa (65/

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