Transition of Chronic Pediatric Nephrological Patients to Adult Care Excluding Patients on Renal Replacement Therapy with Literature Review

Močnik, Mirjam; Jančič, Sonja Golob; Varda, Nataša Marčun

doi:10.3390/children9070959

Cited by 2 publications

(2 citation statements)

References 46 publications

(67 reference statements)

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“…35 The SA transition age contrasts to international centres where the transition age is higher, reported to be between 18-21 years of age. 13,33,[36][37][38] The early age of transition directly impacts the management of AYAs, and patients with complex kidney diseases require an understanding of the nuances related to the age of transition. There is a paucity of data on kidney transition clinics in LMICs.…”

Section: Despite the International Society Of Nephrology (Isn) And Thementioning

confidence: 99%

“…Thirteen is a very young age for patients to transition and engage with adult health care services 35 . The SA transition age contrasts to international centres where the transition age is higher, reported to be between 18–21 years of age 13,33,36–38 . The early age of transition directly impacts the management of AYAs, and patients with complex kidney diseases require an understanding of the nuances related to the age of transition.…”

Section: Importance Of Adolescent and Young Adult Transition Clinicsmentioning

confidence: 99%

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Kidney adolescent and young adult clinic: A transition model in Africa

Barday,

Davidson,

Harden

et al. 2024

Pediatric Transplantation

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Adolescents and Young Adults (AYAs) with chronic kidney disease (CKD) have challenges unique to this developmental period, with increased rates of high‐risk behavior and non‐adherence to therapy which may impact the progression of kidney disease and their requirement for kidney replacement therapy (KRT). Successful transition of AYA patients are particularly important in low‐ and middle‐income countries (LMICs) where KRT is limited, rationed or not available. Kidney AYA transition clinics have the potential to improve clinical outcomes but there is a paucity of data on the clinical translational impact of these clinics in Africa. This review is a reflection of the 20‐year growth and development of the first South African kidney AYA transition clinic. We describe a model of care for patients with CKD, irrespective of etiology, aged 10–25 years, transitioning from pediatric to adult nephrology services. This unique service was established in 2002 and re‐designed in 2015. This multidisciplinary integrated transition model has improved patient outcomes, created peer support groups and formed a training platform for future pediatric and adult nephrologists. In addition, an Adolescent Centre of Excellence has been created to compliment the kidney AYA transition model of care. The development of this transition pathway challenges and solutions are explored in this article. This is the first kidney AYA transition clinic in Africa. The scope of this service has expanded over the last two decades. With limited resources in LMICs, such as KRT, the structured transition of AYAs with kidney disease is not only possible but essential. It is imperative to preserve residual kidney function, maximize the kidney allograft lifespan and improve adherence, to enable young individuals an opportunity to lead productive lives.

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