Kidney Week

Abstract: TH-PO1206

Global Trends in the Burden of Kidney Failure in Pediatric Patients: A Pooled International Analysis, 2000-2023

Session Information

• Pediatric Nephrology: CV Health, CKD, AKI, Dialysis, Transplantation, and Health Services Research
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

• 1800 Pediatric Nephrology

Authors

• Hedin, Erin, University of Alberta, Edmonton, Alberta, Canada

Erin Hedin, MD

• Tungsanga, Somkanya, Chulalongkorn University, Bangkok, Thailand

Somkanya Tungsanga, MD, PhD

• Ye, Feng, University of Alberta, Edmonton, Alberta, Canada

Feng Ye, MS

• Okpechi, Ikechi G., University of Alberta, Edmonton, Alberta, Canada

Ikechi G. Okpechi, MBBS, PhD

• Kung, Janice Y., Geoffrey and Robyn Sperber Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada

Janice Y. Kung

• Dart, Allison, University of Manitoba, Winnipeg, Manitoba, Canada

Allison Dart, MD

• Morgan, Catherine, University of Alberta, Edmonton, Alberta, Canada

Catherine Morgan, MD

• Thompson, Stephanie E., University of Alberta, Edmonton, Alberta, Canada

Stephanie E. Thompson, MD, PhD

• Bello, Aminu K., University of Alberta, Edmonton, Alberta, Canada

Aminu K. Bello, MD, PhD, FASN

Background

Reliable contemporary estimates of the global burden of pediatric kidney failure (KF) remains limited because of heterogeneity in registry coverage, age definitions, and reporting practices across countries and regions. Understanding temporal trends in pediatric KF prevalence is essential to inform kidney health policy, dialysis and transplantation planning, and equitable access to pediatric kidney care worldwide.

Methods

We conducted a pooled longitudinal analysis of pediatric KF prevalence data from international, regional and national renal registries between 2000 and 2023. Prevalence was expressed per million age-related population (pmarp). Annual pooled prevalence and 95% confidence intervals were estimated using DerSimonian and Laird random-effects meta-analysis. The primary analysis included all available pediatric age-group definitions (0–14, 0–17, 0–18, and 0–19 years). Temporal trends were evaluated using annual percentage change (APC). Sensitivity analyses excluded the 0–14-year subgroup to assess the influence of age-group composition.

Results

The meta-analysis included 45 countries contributing 696 country-years of data after applying selection rules to avoid overlapping estimates. Pooled pediatric KF prevalence was 57.0 pmarp (95%CI 46.2-68.9) in 2000 and 55.3 pmarp (95% CI 48.3, 62.8) in 2023. Inclusion of all pediatric age groups resulted in an apparent decline in pooled prevalence after 2010. Segmented trend analysis showed minimal change before 2010 (APC 0.64%, p=0.569) and a modest increase thereafter (APC 1.82%, p=0.041). Excluding the 0–14-year subgroup produced substantially more stable prevalence over time (APC 0.10%, p=0.835), suggesting that variation in age-group definitions and registry composition substantially influenced pooled global estimates.

Conclusion

Global pooled estimates of pediatric KF prevalence are stable and highly sensitive to variation in age-group definitions and registry composition. While combining all available pediatric age groups may maximize inclusiveness and international comparability, interpretation of temporal trends requires careful consideration of changes in registry participation and age-structure reporting over time. These findings underscore the need for standardized pediatric kidney surveillance frameworks and harmonization of age-stratified reporting across international registries.