Lessons learned from efforts to improve the quality of care in children with end-stage renal disease in the Netherlands and Belgium

摘要

In contrast to the situation in adults, ESRD in children is a rare disorder: in the Western world, the annual incidence rate of ESRD in patients <19 years of age is about 6-8 per million age related population. In a population of 3.9 million people below the age of 20 years in the Netherlands3 and 2.5 million in Belgium,4 this implies on average about 30 new patients per year in the Netherlands and 20 in Belgium. So that patients do not have to travel too far for treatment, there are four dialysis centres in the Netherlands and six in Belgium; consequently all dialysis centres are very small. ESRD in children is a serious and life-threatening disorder. Data on long term outcomes show that overall mortality in young adults is about 30 times increased and the risk for cardiovascular death is increased more than 100 times compared to an age related population.