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Girimaji N, Pais P, Iyengar A. Transition of Kidney Care at 18: Challenges and Practical Solutions for India. Indian J Nephrol 2023; 33:325-332. [PMID: 37881731 PMCID: PMC10593299 DOI: 10.4103/ijn.ijn_253_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 08/30/2022] [Indexed: 10/27/2023] Open
Abstract
Health-care transition (HCT) from pediatric-centered to adult-oriented health-care setting is more than a simple transfer of care. It is a carefully planned movement specially tailored for the needs of adolescents and young adults (AYAs). Similar to other chronic diseases, the need for HCT for AYAs with kidney disease has been well established by the International Society of Nephrology (ISN) and the International Pediatric Nephrology Association (IPNA) consensus statements since 2011. However, successful HCT in India and other low- and middle-income countries (LMICs) has been limited. Undertaking the HCT program in India requires involvement of many stakeholders, that is, AYAs, parents/caregivers, health-care providers, and the health-care system. In this article, we discuss the need for HCT, the challenges faced during the transition, and the recommended models for HCT in kidney care. We focus on the unique challenges faced in India and conclude with practical suggestions to implement HCT in our setting.
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Affiliation(s)
- Niveditha Girimaji
- Department of Pediatric Nephrology, St. John’s Medical College, Bengaluru, Karnataka, India
| | - Priya Pais
- Department of Pediatric Nephrology, St. John’s Medical College, Bengaluru, Karnataka, India
| | - Arpana Iyengar
- Department of Pediatric Nephrology, St. John’s Medical College, Bengaluru, Karnataka, India
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Dawson AE, Wilson CS, Smoyer WE, Pottanat N, Wilson AC, Mahan JD, LaMotte JE. Psychosocial supports within pediatric nephrology practices: A pediatric nephrology research consortium survey. PLoS One 2023; 18:e0285126. [PMID: 37159451 PMCID: PMC10168552 DOI: 10.1371/journal.pone.0285126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 04/15/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND The landscape of available psychosocial services within pediatric nephrology care is poorly characterized. However, the effects of kidney disease on emotional health and health-related quality of life are well documented, as is the impact of social determinants of health on kidney disease outcomes. The objectives of this study were to assess pediatric nephrologists' perceptions of available psychosocial services and to elucidate inequities in access to psychosocial care. METHODS A web-based survey was distributed to members of the Pediatric Nephrology Research Consortium (PNRC). Quantitative analyses were performed. RESULTS We received responses from 49 of the 90 PNRC centers. With regards to dedicated services, social work was most commonly available (45.5-100%), followed by pediatric psychology (0-57.1%) and neuropsychology (0-14.3%), with no centers having embedded psychiatry. Availability of psychosocial providers was positively associated with nephrology division size, such that as center size increased, access to various psychosocial providers increased. Notably, the majority of respondents indicated that perceived need for psychosocial support exceeds that which is currently available, even at centers with higher levels of current support. CONCLUSIONS Within the US, there is wide variability in the availability of psychosocial services within pediatric nephrology centers despite a well-documented necessity for the provision of holistic care. Much work remains to better understand the variation in funding for psychosocial services and in utilization of psychosocial professionals in the pediatric nephrology clinic, and to inform key best practices for addressing the psychosocial needs of patients with kidney disease.
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Affiliation(s)
- Anne E Dawson
- Department of Psychology and Pediatric Neuropsychology, Nationwide Children's Hospital, Columbus, OH, United States of America
- Department of Pediatrics, The Ohio State University, Columbus, OH, United States of America
| | - Camille S Wilson
- Department of Psychology and Pediatric Neuropsychology, Nationwide Children's Hospital, Columbus, OH, United States of America
- Department of Pediatrics, The Ohio State University, Columbus, OH, United States of America
| | - William E Smoyer
- Department of Pediatrics, The Ohio State University, Columbus, OH, United States of America
- Center for Clinical and Translational Research, Nationwide Children's Hospital, Columbus, OH, United States of America
| | - Neha Pottanat
- Division of Nephrology, Riley Hospital for Children, Indianapolis, IN, United States of America
- Division of Hematology/Oncology, Riley Hospital for Children, Indianapolis, IN, United States of America
| | - Amy C Wilson
- Division of Nephrology, Riley Hospital for Children, Indianapolis, IN, United States of America
- Division of Hematology/Oncology, Riley Hospital for Children, Indianapolis, IN, United States of America
| | - John D Mahan
- Department of Pediatrics, The Ohio State University, Columbus, OH, United States of America
| | - Julia E LaMotte
- Division of Hematology/Oncology, Riley Hospital for Children, Indianapolis, IN, United States of America
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States of America
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Kotanko P, Rosales L, Ronco C. 23rd International Conference on Dialysis: Advances in Chronic Kidney Disease 2021 (April 20-23, 2021, USA). Blood Purif 2021; 50:591-594. [PMID: 34198286 DOI: 10.1159/000517786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Peter Kotanko
- Renal Research Institute, New York, New York, USA.,Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Claudio Ronco
- Department of Medicine, University of Padova, Padova, Italy.,International Renal Research Institute of Vicenza, Vicenza, Italy.,Department of Nephrology, San Bortolo Hospital, Vicenza, Italy
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