Improving Pediatric Renal Health: Clinical Public Health Strategies and Nephrology-Focused Nursing Interventions for Long-Term Outcomes
DOI:
https://doi.org/10.65327/kidneys.v15i1.629Keywords:
Pediatric nephrology; renal nursing; public health; chronic kidney disease; acute kidney injuryAbstract
Pediatric kidney diseases present a significant clinical and societal health burden in terms of frequent morbidity, impaired function and threat of enduring morbidity. This study compared integrated clinical public health approaches and nephrology-oriented nursing care to the outcome of pediatric renal disease. A descriptive observational study involved children aged 0-18 years old with chronic kidney disease (CKD), acute kidney injury (AKI), and nephrotic syndrome. Outcome patterns and predictors of renal improvement were studied using descriptive statistics, comparative statistics, and regression modelling. This cohort involved 120 children (mean age of 9.4 years, 32% AKI, 48% CKD, 20% nephrotic syndrome). Mean estimated glomerular filtration rate (eGFR) rose to 45% at 6 months and 52% at 12 months; baseline eGFR 38mL/min/m2. The adherence rate also improved to 84% versus 62% and the quality of life improved to 71/100 compared to 48/100. The episodes of AKI reduced from 32% to 14%, infections from 41% to 19%, hypertension from 36% to 22%, nephrotic-syndrome-relapse from 28% to 12%, and the hospitalisation rate from 1.8 to 0.9 per patient-year. The regression analysis revealed that the following factors were significant predictors of renal improvement: nursing intensity (β = 0.41, p < 0.01), early screening participation (β = 0.36, p < 0.01), tele-support frequency (β = 0.33, p < 0.05), and home-care engagement (β = 0.29, p < 0.05). The long-term renal health of pediatric patients can be enhanced by a multidisciplinary approach and effective nursing leadership, screening in the early stages, and structured home-based instruction.
Downloads
References
Konrad B. Exploring Teaching Strategies for Nephrology Nurse Educators (Doctoral dissertation, Capella University).
Nataatmadja M, Graham J, Beaulieu M, Zalunardo N, Levin A. The role of the chronic kidney disease clinic and multidisciplinary team care. Chronic kidney disease, dialysis and transplantation: A companion to Brenner and Rector's the kidney. 2018 Nov 6:121-35.
Wang N, Deng X, Zhang T, Tao Y, Feng Q. Knowledge, Attitude, and Practice of Nurses in Preventing Complications in Patients with Nephrotic Syndrome: A Cross-Sectional Study. Therapeutics and Clinical Risk Management. 2025 Dec 31:1295-305.
Bunchman TE. Renal Replacement Therapies. In Pediatric Critical Care: Text and Study Guide 2021 Mar 16 (pp. 983-1000). Cham: Springer International Publishing.
Schwartz SR, Vuong KT, Obregon E, Marlais M, Starr M, Askenazi D. Renal replacement therapy in the neonatal intensive care unit: balancing neonatal expertise with practicality—Proceedings from the First International Neonatal Nephrology Symposium. Pediatric Research. 2025 Oct 3:1-2.
Sheikh MS, Kashani KB, Gregoire JR, Thongprayoon C, Miao J, Craici IM, Cheungpasitporn W, Qureshi FM. Digital transformation of nephrology POCUS education—Integrating a multi-agent, artificial intelligence, and human collaboration-enhanced curriculum with expert feedback. Digital Health. 2025 Mar;11:20552076251328807.
Baragar BH, Schorr M, Verdin N, Woodlock T, Clark DA, Hundemer GL, Mathew A, Mustafa RA, Ryz KS, Harrison TG. Identification and prioritization of Canadian society of nephrology clinical practice guideline topics with multidisciplinary stakeholders and people living with kidney disease: a clinical research protocol. Canadian Journal of Kidney Health and Disease. 2023 Nov;10:20543581231207142.
Bohorques R, Alfonzo J, Almaguer M, Alvarez Y, Florín J, Guerra G, Leyva C, Magrans C, Perez-Oliva J, Rivas R. Nephrology in Cuba. InNephrology Worldwide 2021 Mar 4 (pp. 147-156). Cham: Springer International Publishing.
Pham JH, Thongprayoon C, Suppadungsuk S, Miao J, Craici IM, Cheungpasitporn W. Digital health tools in nephrology: a comparative analysis of AI and professional opinions via online polls. Digital Health. 2024 Aug;10:20552076241277458.
Neha F, Bhati D, Shukla DK. Generative AI Models (2018–2024): Advancements and Applications in Kidney Care. BioMedInformatics. 2025 Apr 3;5(2):18.
Cunningham A, Hung W, Levin A, Jamal A. Adapting nephrology training curriculum in the era of COVID-19. Canadian Journal of Kidney Health and Disease. 2021 Feb;8:2054358120988446.
Odom B, Elliott S, Barrios CG. Promoting Patient and Nurse Safety in Acute Dialysis Units Through Advocacy and Collaboration. Nephrology Nursing Journal. 2021 Mar 1;48(2).
Seaborg E, Kuehn BM. Targeted Efforts Needed to Combat Kidney Failure in Native Hawaiians, Pacific Islanders.
Mehl KR, Morain SR, Sugarman J. Empirical research related to the ethics of pragmatic clinical trials: A scoping review. Learning Health Systems. 2025:e70041.
Quigley L, Salsberg E, Collins A. Early Career Nephrologists: Results of a 2017 Survey (Doctoral dissertation, George Washington University).
Maddux DW, Usvyat LA, Blanchard T, Jiao Y, Kotanko P, van der Sande FM, Kooman JP, Maddux FW. Transition period clinical trajectories for PD versus HD starters. Peritoneal Dialysis International. 2019 Jan;39(1):42-50.
Gu L, Gross AC, Kizilbash S. Multidisciplinary approach to optimizing long-term outcomes in pediatric kidney transplant recipients: multifaceted needs, risk assessment strategies, and potential interventions. Pediatric Nephrology. 2025 Mar;40(3):661-73.
Joshi R, John O, Jha V. The potential impact of public health interventions in preventing kidney disease. InSeminars in nephrology 2017 May 1 (Vol. 37, No. 3, pp. 234-244). WB Saunders.
Wang Y, Liu F, Ni D, Liu J. The Impact of Prolonged Home Care on Nursing Adherence and Overall Quality of Life Among Pediatric Patients Diagnosed with Nephrotic Syndrome. Alternative Therapies in Health and Medicine. 2023 Nov 1;29(8):144-9.
Raju TN, Pemberton VL, Saigal S, Blaisdell CJ, Moxey-Mims M, Buist S. Long-term healthcare outcomes of preterm birth: an executive summary of a conference sponsored by the National Institutes of Health. The Journal of pediatrics. 2017 Feb 1;181:309-18.
Francis A, Shroff R, Earley A, Foster BJ. KDIGO 2024 Guidelines—Key Points for Pediatricians. JAMA pediatrics. 2025 Feb 1;179(2):114-6.
AlNafisi A, Al-Dmour A, Patel R, Premkumar S, Verma S, Bahadori A, Marks SD, Robinson C, Selvathesan N. Acute Kidney Injury in Children: Current Understanding and Future Directions. Current Pediatrics Reports. 2025 Aug 2;13(1):20.
Kil SY, Yang WS, Kim YN, Shin HS, Jung Y, Rim H. Genes, kidneys, and the future: transforming chronic kidney disease management through genomic insights. Childhood Kidney Diseases. 2025 Jun 27;29(2):39-45.
Menon S, Symons JM, Selewski DT. Acute kidney injury. Pediatrics in review. 2023 May 1;44(5):265-79.
Brophy PD. Overview on the challenges and benefits of using telehealth tools in a pediatric population. Advances in Chronic Kidney Disease. 2017 Jan 1;24(1):17-21.
ISSN 2307-1257
ISSN 2307-1265
