The impact of rural status on pediatric chronic kidney disease.
Document Type
Article
Publication Date
2-2024
Identifier
DOI: 10.1007/s00467-023-06001-0; PMCID: PMC10182542
Abstract
Children and adolescents in rural areas with chronic kidney disease (CKD) face unique challenges related to accessing pediatric nephrology care. Challenges to obtaining care begin with living increased distances from pediatric health care centers. Recent trends of increasing centralization of pediatric care mean fewer locations have pediatric nephrology, inpatient, and intensive care services. In addition, access to care for rural populations expands beyond distance and encompasses domains of approachability, acceptability, availability and accommodation, affordability, and appropriateness. Furthermore, the current literature identifies additional barriers to care for rural patients that include limited resources, including finances, education, and community/neighborhood social resources. Rural pediatric kidney failure patients have barriers to kidney replacement therapy options that may be even more limited for rural pediatric kidney failure patients when compared to rural adults with kidney failure. This educational review identifies possible strategies to improve health systems for rural CKD patients and their families: (1) increasing rural patient and hospital/clinic representation and focus in research, (2) understanding and mediating gaps in the geographic distribution of the pediatric nephrology workforce, (3) introducing regionalization models for delivering pediatric nephrology care to geographic areas, and (4) employing telehealth to expand the geographic reach of services and reduce family time and travel burden.
Journal Title
Pediatric nephrology (Berlin, Germany)
Volume
39
Issue
2
First Page
435
Last Page
446
MeSH Keywords
Adult; Adolescent; Humans; Child; Rural Population; Telemedicine; Nephrology; Renal Insufficiency, Chronic; Renal Insufficiency; Health Services Accessibility
Keywords
Health services accessibility; Kidney failure; Pediatrics; Rural health; Rural populations
Recommended Citation
Swanson MB, Weidemann DK, Harshman LA. The impact of rural status on pediatric chronic kidney disease. Pediatr Nephrol. 2024;39(2):435-446. doi:10.1007/s00467-023-06001-0
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