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Background: The global pediatric nephrology workforce is poorly characterized. The objectives of our study were to assess pediatric nephrologists' perceptions of the adequacy of the pediatric nephrology workforce, and understand regional challenges to fellow recruitment and job acquisition. Perceptions regarding optimal length of training and research requirements were also queried. Methods: A 17-question web-based survey comprised of 14 close-ended and 3 open-ended questions was e-mailed to members of the International Pediatric Nephrology Association. Quantitative and qualitative analyses were performed. Results: We received 341 responses from members of the International Pediatric Nephrology Association from 71 countries. There was a high degree of overall perceived workforce inadequacy with 67 % of all respondents reporting some degree of shortage. Perceived workforce shortage ranged from 20 % in Australia/New Zealand to 100 % in Africa. Respondents from Africa (25 %) and North America (22.4 %) reported the greatest difficulty recruiting fellows. Respondents from Australia/New Zealand (53.3 %) and Latin America (31.3 %) reported the greatest perceived difficulty finding jobs as pediatric nephrologists after training. Low trainee interest, low salary, lack of government or institutional support, and few available jobs in pediatric nephrology were the most frequently reported obstacles to fellow recruitment and job availability. Conclusions: Globally, there is a high level of perceived inadequacy in the pediatric nephrology workforce. Regional variability exists in perceived workforce adequacy, ease of recruitment, and job acquisition. Interventions to improve recruitment targeted to specific regional barriers are suggested.

Abstract Background The global pediatric nephrology workforce is poorly characterized. The objectives of our study were to assess pediatric nephrologists' perceptions of the adequacy of the pediatric nephrology workforce, and understand regional challenges to fellow recruitment and job acquisition. Perceptions regarding optimal length of training and research requirements were also queried. Methods A 17-question web-based survey comprised of 14 close-ended and 3 open-ended questions was e-mailed to members of the International Pediatric Nephrology Association. Quantitative and qualitative analyses were performed. Results We received 341 responses from members of the International Pediatric Nephrology Association from 71 countries. There was a high degree of overall perceived workforce inadequacy with 67 % of all respondents reporting some degree of shortage. Perceived workforce shortage ranged from 20 % in Australia/New Zealand to 100 % in Africa. Respondents from Africa (25 %) and North America (22.4 %) reported the greatest difficulty recruiting fellows. Respondents from Australia/New Zealand (53.3 %) and Latin America (31.3 %) reported the greatest perceived difficulty finding jobs as pediatric nephrologists after training. Low trainee interest, low salary, lack of government or institutional support, and few available jobs in pediatric nephrology were the most frequently reported obstacles to fellow recruitment and job availability. Conclusions Globally, there is a high level of perceived inadequacy in the pediatric nephrology workforce. Regional variability exists in perceived workforce adequacy, ease of recruitment, and job acquisition. Interventions to improve recruitment targeted to specific regional barriers are suggested.

Cover -- Contributions to Nephrology Vol. 199 -- Nephrology and Public Health Worldwide -- Contents -- Preface -- Public Health and Nephrology: Contributions of Epidemiology to the Study, Understanding, Prevention and Treatment of Kidney Disease -- Abstract -- Introduction -- Defining Public Health -- The Burden of Kidney Diseases -- Kidney Health Reflects Societal Health -- Epidemiology -- Observational Studies -- Epidemiology in Quantifying Public Health Problems -- Experimental Studies -- Conclusion -- Disclosure Statement -- References -- Dietary Patterns for Promoting Kidney Health -- Abstract -- Introduction -- CKD Magnitude and Its Association with Nutrition -- Dietary Patterns in CKD Treatment -- Dietary Patterns in the Prevention of CKD -- Take-Home Messages -- Disclosure Statement -- References -- Nutrition and Obesity Impacts on Kidney Health -- Abstract -- Introduction -- Nutrition -- Obesity -- Take Home Messages -- Disclosure Statement -- References -- Physical Activity and Health in Chronic KidneyDisease -- Abstract -- Introduction -- Physical Inactivity and CKD: A Global Health Problem -- Physical Activity across the Spectrum of CKD -- Poor Physical Function in CKD and Its Causes -- Challenges to Improving Physical Activity and Function in CKD -- Strategies for Improving Physical Inactivity and Dysfunction in CKD -- Take Home Messages -- Disclosure Statement -- References -- Sepsis and Kidney Injury -- Abstract -- Introduction -- Scientific Background and Clinical Context - Definitions -- Epidemiologic Situation -- Main Challenges/Solutions -- Patient Identification and Care Bundles -- Therapeutic Options -- Take Home Messages -- Disclosure Statement -- References -- Heart Disease and the Kidneys -- Abstract -- Cardio-Renal Syndrome -- Chronic Kidney Disease and Coronary Heart Disease -- Take-Home Messages -- Disclosure Statement.

Nephrology is a young medical specialty that has evolved and expanded during the last 4 decades of the past century, becoming recognized as one of the most innovative and challenging medical specialties. The training of nephrology takes place mainly in public hospitals, and there are important variations in the duration and assessment of training among the European countries. The Union of European Medical Specialties (UEMS) Renal Section and the European Renal Association–European Dialysis and Transplant Association have been working jointly since 2010 to harmonize European nephrology training and more recently to establish the European Certificate in Nephrology (ECN). The first two editions of the ECN were held in early 2017 and 2018. In total, 122 candidates from 26 countries have sat for the exam, with a success rate of 59% (72/122). To date, Switzerland has adopted the exam as their national training assessment and we expect that other countries will join Switzerland in the near future. Fostering the development and importance of the ECN requires that member states work to increase the academic and professional profile of the ECN within their countries. The ECN should be considered a 'quality mark' and a sign of high achievement in nephrology training in Europe. If holding the ECN becomes advantageous for employment or improving scientific careers, the number of candidates will increase and the sustainability of the ECN will be guaranteed. A recent, positive development is the pre-agreement between the UEMS Renal Section, UK Renal Association and Royal Colleges of the UK to adopt a unique pan-European exam beginning in 2020. However, any decision to commence the pan-European exam will depend, in part, on strong candidate enrolment for the ECN 2019 edition. Thus support of the national societies is crucial for the sustainability and growth of a European exam, because of their capacities to influence strategic policies in hospitals, universities and medical associations, with a longer-term aim to increase the ...

This article provides some background on military nephrology in the UK. The primary objective of the Defence Medical Services is the maintenance of operational capability of military personnel. This includes exclusion of nephrological diseases that might reduce renal reserve to a critical level under field conditions, increasing susceptibility to trauma, burns, infection and adverse environmental conditions and increasing the need for renal support. Renal failure potentially compromises not only the patient but also his comrades through reduced staffing and inability to execute the military mission. Safety of weapon systems for which the patient is responsible may be reduced. At forward locations, need for evacuation may put aircraft or vehicles and their crew with medical attendants at unnecessary risk. Regular follow-up and continuity of care are difficult owing to the demands of military life that include frequent postings and deployments.

Nephrology is a young medical specialty that has evolved and expanded during the last 4 decades of the past century, becoming recognized as one of the most innovative and challenging medical specialties. The training of nephrology takes place mainly in public hospitals, and there are important variations in the duration and assessment of training among the European countries. The Union of European Medical Specialties (UEMS) Renal Section and the European Renal Association-European Dialysis and Transplant Association have been working jointly since 2010 to harmonize European nephrology training and more recently to establish the European Certificate in Nephrology (ECN). The first two editions of the ECN were held in early 2017 and 2018. In total, 122 candidates from 26 countries have sat for the exam, with a success rate of 59% (72/122). To date, Switzerland has adopted the exam as their national training assessment and we expect that other countries will join Switzerland in the near future. Fostering the development and importance of the ECN requires that member states work to increase the academic and professional profile of the ECN within their countries. The ECN should be considered a 'quality mark' and a sign of high achievement in nephrology training in Europe. If holding the ECN becomes advantageous for employment or improving scientific careers, the number of candidates will increase and the sustainability of the ECN will be guaranteed. A recent, positive development is the pre-agreement between the UEMS Renal Section, UK Renal Association and Royal Colleges of the UK to adopt a unique pan-European exam beginning in 2020. However, any decision to commence the pan-European exam will depend, in part, on strong candidate enrolment for the ECN 2019 edition. Thus support of the national societies is crucial for the sustainability and growth of a European exam, because of their capacities to influence strategic policies in hospitals, universities and medical associations, with a longer-term aim to increase the professional recognition of the European exam. ; info:eu-repo/semantics/publishedVersion

The social and economic burdens of dialysis are growing worldwide as the number of patients increases. Dialysis is becoming a heavy burden even in developed countries. Thus, preventing end-stage kidney disease is of the utmost importance. Early detection and treatment is recommended because late referral is common, with most chronic kidney disease (CKD) patients remaining asymptomatic until a late stage. Three-quarters of dialysis patients initiated dialysis therapy within 1 year after referral to the facility. Since its introduction in 2002, the definition of CKD has been widely accepted not only by nephrologists but also by other medical specialties, such as cardiologists and general practitioners. Japan has a long history of general screening for school children, university students, and employees of companies and government offices, with everybody asked to participate. The urine test for proteinuria and hematuria is popular among Japanese people; however, the outcomes have not been well studied. We examined the effects of clinical and laboratory data from several sources on survival of dialysis patients and also predictors of developing dialysis from community-based screening (Okinawa Dialysis Study, OKIDS). At an early CKD stage, patients are usually asymptomatic; therefore, regular health checks using a urine dipstick and serum creatinine are recommended. The intervals for follow-up, however, are debatable due to the cost. CKD is a strong risk factor for developing cardiovascular disease and death and also plays an important role in infection and malignancies, particularly in elderly people. People can live longer with healthy kidneys.

The 1960s heralded an era when rapid advances in technology led to tremendous advances in medicine. We describe how the European Society for Paediatric Nephrology (ESPN) marked its 50th anniversary by creating an oral video archive from early pioneers treating children with kidney diseases. Today's inexpensive technology democratises the ability to preserve medical history for future generations in a vivid form.

Incorrect prescription and administration of medications account for a substantial proportion of medical errors in the USA, causing adverse drug events (ADEs) that result in considerable patient morbidity and enormous costs to the health-care system. Patients with chronic kidney disease or acute kidney injury often have impaired drug clearance as well as polypharmacy, and are therefore at increased risk of experiencing ADEs. Studies have demonstrated that recognition of these conditions is not uniform among treating physicians, and prescribed drug doses are often incorrect. Early interventions that ensure appropriate drug dosing in this group of patients have shown encouraging results. Both computerized physician order entry and clinical decision support systems have been shown to reduce the rate of ADEs. Nevertheless, these systems have been implemented at surprisingly few institutions. Economic stimulus and health-care reform legislation present a rare opportunity to refine these systems and understand how they could be implemented more widely. Failure to explore this technology could mean that the opportunity to reduce the morbidity associated with ADEs is missed.

Objective: To identify how Nephrology has been developing within the Nursing, and the profile of nurses working in hemodialysis clinics in Recife and the Metropolitan Region. Method: cross-sectional study, exploratory quantitative approach, developed in 14 hemodialysis clinics. The sample consisted of 84 nurses. The data were collected through a questionnaire was completed. Data analysis was performed with SPSS version 13. Approved research protocol number 2151-11 and CAAE No. 0280.0.099.000-10. Results: nurses have specialist title in Nephrology (66,7%), and acquired on average 62,8 months after the start of the activity in the area. Achievements were reached by category, such as professional autonomy, recognition and respect for patients and society. Conclusion: non-specialized nurses are being admitted to hemodialysis services due to the lack of these professionals in the job market.

Background: The burden of kidney diseases is reported to be higher in lower- and middle-income countries as compared to developed countries, and countries in sub-Saharan Africa are reported to be most affected. Health systems in most sub-Sahara African countries have limited capacity in the form of trained and skilled health care providers, diagnostic support, equipment and policies to provide nephrology services. Several initiatives have been implemented to support establishment of these services. Methods: This is a situation analysis to examine the nephrology services in Tanzania. It was conducted by interviewing key personnel in institutions providing nephrology services aiming at describing available services and international collaborators supporting nephrology services. Results: Tanzania is a low-income country in Sub-Saharan Africa with a population of more than 55 million that has seen remarkable improvement in the provision of nephrology services and these include increase in the number of nephrologists to 14 in 2018 from one in 2006, increase in number of dialysis units from one unit (0.03 unit per million) before 2007 to 28 units (0.5 units per million) in 2018 and improved diagnostic services with introduction of nephropathology services. Government of Tanzania has been providing kidney transplantation services by funding referral of donor and recipients abroad and has now introduced local transplantation services in two hospitals. There have been strong international collaborators who have supported nephrology services and establishment of nephrology training in Tanzania. Conclusion: Tanzania has seen remarkable achievement in provision of nephrology services and provides an interesting model to be used in supporting nephrology services in low income countries. ; publishedVersion

The Health workforce is the foundation of any medical services framework. A well-prepared and adequately staffed staff is essential for achieving comprehensive inclusion in the welfare field. Specifically, a nephrology staff is essential to address overall load of developing kidney illness. In spite of some efforts, worldwide limit of the nephrology staff and preparedness remains largely unclear. Our current global cross-sectional overview has been produced as part of the World Atlas of Kidney Health; another activity monitored by Worldwide Culture of Nephrology. The purpose of this survey was to examine the current status of worldwide nephrology staff and to prepare a boundary. The survey was web-monitored, and all information was reviewed and entered by the local ISN offices and the World Bank country group. Our current research was conducted at BVH Bahawalpur from January 2019 to December 2019. Overall, 135 UN Member States replied to whole survey, and 126 nations responded to the general nephrology workforce questions. The number of nephrologists in the world was 9.84 per million people; high-wage nations described the number of nephrologists of 29.54 PMP in comparison and 0.32 PMP in low-wage countries. As a result, the global workforce of Nephrologists was 2.89 PMP; high salary states described a workforce of Nephrologists 35 times thicker than low salary countries (7.04 PMP versus 0.19 PMP). Nations reported the shortage of all nephrology service earners. A nephrology preparation programme occurred in 80% of nations, ranging from 99% in huge salary nations to 43% in low salary nations. In nations by the preparation programme, the dominant share (87%) of projects remained 3 to 5 years, also best known preparation structure (57%) followed general internal medication. Authors found a noticeable variety in global thickness of nephrologists and nephrology students and gaps in altogether providers of nephrology consideration; aim was progressively noticeable in low-wage nations, mainly in the ISN areas of ...

The Colombian Association of Nephrology and Arterial Hypertension, since the legalization of new statutes by the Chamber of Commerce of Bogotá, has become a scientific and union-based organization that assumes its mission objective by instituting as an organized civil society. This establishes, so to speak, on the area of social science, and is made up of different people with a civic view, that act collectively in the public sphere to make decisions concerning all citizens outside government structures.It is the civil societies, NGOs, professional associations, clubs, religious communities, etc., that is, the civil society is, in principle, created in order to make decisions in political matters that, one way or another, affect government behaviors.

A well-prepared and adequately staffed staff is essential for achieving comprehensive inclusion in the welfare field. Specifically, a nephrology staff is essential to address overall load of developing kidney illness. In spite of some efforts, worldwide limit of the nephrology staff and preparedness remains largely unclear. Our current global cross-sectional overview has been produced as part of the World Atlas of Kidney Health; another activity monitored by Worldwide Culture of Nephrology. The purpose of this survey was to examine the current status of worldwide nephrology staff and to prepare a boundary. The survey was web-monitored, and all information was reviewed and entered by the local ISN offices and the World Bank country group. Our current research was conducted at BVH Bahawalpur from January 2019 to December 2019. Overall, 135 UN Member States replied to whole survey, and 126 nations responded to the general nephrology workforce questions. The number of nephrologists in the world was 9.84 per million people; high-wage nations described the number of nephrologists of 29.54 PMP in comparison and 0.32 PMP in low-wage countries. As a result, the global workforce of Nephrologists was 2.89 PMP; high salary states described a workforce of Nephrologists 35 times thicker than low salary countries (7.04 PMP versus 0.19 PMP). Nations reported the shortage of all nephrology service earners. A nephrology preparation programme occurred in 80% of nations, ranging from 99% in huge salary nations to 43% in low salary nations. In nations by the preparation programme, the dominant share (87%) of projects remained 3 to 5 years, also best known preparation structure (57%) followed general internal medication. Authors found a noticeable variety in global thickness of nephrologists and nephrology students and gaps in altogether providers of nephrology consideration; aim was progressively noticeable in low-wage nations, mainly in the ISN areas of Africa and South Asia. These findings highlight huge gaps in our existing ...