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Abstract: FR-PO1159

Distribution of the Pediatric Refugee Population with Renal Replacement Therapy in Germany

Session Information

  • Pediatric Nephrology - I
    October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1600 Pediatric Nephrology

Authors

  • Lemke, Johanna, Universtiy Childrens Hospital Hamburg Eppendorf, Hamburg, Germany
  • Schild, Raphael, Universtiy Childrens Hospital Hamburg Eppendorf, Hamburg, Germany
  • Pape, Lars, Hannover Medical School, Hannover, Germany
  • Oh, Jun, Universtiy Childrens Hospital Hamburg Eppendorf, Hamburg, Germany

Group or Team Name

  • and Members of the German Society for Pediatric Nephrology (GPN)
Background

In 2016, about 2 million people immigrated to the EU. With 1 million people Germany reported the largest number of immigrants, of which an estimated 300,000 were children. Data on prevalence and management of refugee patients with end-stage renal disease are rare. Numbers focusing on the pediatric cohort are not available. Our goal was to obtain information on the size and distribution of the pediatric refugee population with renal replacement therapy (RRT). In addition, we wanted to gain insights into the problems and challenges in the care of these patients.

Methods

We interviewed all pediatric dialysis centers in Germany about the number of pediatric refugee patients on RRT at the time of the survey. We also asked the number of patients from the most common countries of origin (Syria, Afghanistan and Iraq). Subjective problems and challenges in the care of this cohort should be listed.

Results

86% of the centers indicated that they provide care to refugee children on RRT. A total of 69 refugee children were treated with RRT in the centers surveyed. 52/69 (75%) received dialysis therapy, 43 of which were on HD and 9 on PD. 17/69 children (25%) underwent RTx. 34/69 (46%) came from either Syria, Afghanistan or Iraq. In 2017 a total of 232 children were on dialysis in Germany, which makes the group of dialyzed refugee children account for approximately 22% of the total German pediatric dialysis population. With regard to the challenges in the care of these patients, difficulties in communication, non-compliance, administrative as well as psychosocial problems were most frequently mentioned. In summary, most centers indicated that the care of this group of patients presents their institution with great financial and logistical challenges.

Conclusion

Our survey shows that the majority of pediatric dialysis centers care for refugee children. The refugee population represents a large proportion of the total pediatric dialysis population in Germany. The challenges in treating these patients are complex and consume many personnel and logistical resources. To ensure holistic care for these children close cooperation between medical staff, dieticians, social workers, interpreters and psychologists is required. Interdisciplinary training should be established in the treating centers. The additional burden should be registered and compensated for by public authorities.