Moving on: transitioning young people with chronic kidney disease to adult care
Advances in the care of children mean that adolescents with chronic kidney disease (CKD) are surviving to adulthood and requiring transition to adult care. The transition phase is well-recognised to be associated with considerable excess morbidity and graft loss, but these outcomes may be avoidable through a structured transition programme. This review will discuss the (1) challenges encountered by patients with CKD, caregivers and clinicians during transition; (2) predictors and outcomes of transition; (3) current guidelines on transition from paediatric to adult renal services; (4) interventions and research directions that may help to improve the care and outcomes for young people with CKD in transition. In spite of the substantial improvement in health gains required for this disadvantaged population, there is to date only limited evidence on the effects of current transition programmes.
KeywordsAdolescent Child Chronic renal insufficiency Graft survival Kidney transplantation Transition to adult care Young adult
Compliance with ethical standards
Conflict of interest
The authors declare no conflict of interest.
- 3.ANZDATA Registry (2016) 38th Report, chapter 2: prevalence of end stage kidney disease. Australia and New Zealand Dialysis and Transplant Registry, AdelaideGoogle Scholar
- 4.Saran R, Li Y, Robinson B, Abbott KC, Agodoa LY, Ayanian J, Bragg-Gresham J, Balkrishnan R, Chen JL, Cope E, Eggers PW, Gillen D, Gipson D, Hailpern SM, Hall YN, He K, Herman W, Heung M, Hirth RA, Hutton D, Jacobsen SJ, Kalantar-Zadeh K, Kovesdy CP, Lu Y, Molnar MZ, Morgenstern H, Nallamothu B, Nguyen DV, O’Hare AM, Plattner B, Pisoni R, Port FK, Rao P, Rhee CM, Sakhuja A, Schaubel DE, Selewski DT, Shahinian V, Sim JJ, Song P, Streja E, Kurella Tamura M, Tentori F, White S, Woodside K, Hirth RA (2016) US renal data system 2015 annual data report: epidemiology of kidney disease in the United States. Am J Kidney Dis 67(Svii):S1–305Google Scholar
- 6.Perry EE, Zheng K, Ferris ME, Torres L, Bickford K, Segal JH (2011) Invited manuscript poster on renal-related education American Society of Nephrology, Nov. 16–21, 2010. Adolescents with chronic kidney disease and their need for online peer mentoring: a qualitative investigation of social support and healthcare transition. Ren Fail 33:663–668CrossRefPubMedGoogle Scholar
- 11.Watson AR, Harden P, Ferris M, Kerr PG, Mahan J, Ramzy MF (2011) Transition from pediatric to adult renal services: a consensus statement by the International Society of Nephrology (ISN) and the International pediatric nephrology Association (IPNA). Pediatr Nephrol 26:1753–1757CrossRefPubMedGoogle Scholar
- 34.Forbes TA, Watson AR, Zurowska A, Shroff R, Bakkaloglu S, Vondrak K, Fischbach M, Van de Walle J, Ariceta G, Edefonti A, Aufricht C, Jankauskiene A, Holta T, Ekim M, Schmitt CP, Stefanidis C, European Paediatric Dialysis Working Group (2014) Adherence to transition guidelines in European paediatric nephrology units. Pediatr Nephrol 29:1617–1624CrossRefPubMedGoogle Scholar
- 50.Fenton N, Ferris M, Ko Z, Javalkar K, Hooper SR (2015) The relationship of health care transition readiness to disease-related characteristics, psychosocial factors, and health care outcomes: preliminary findings in adolescents with chronic kidney disease. J Pediatr Rehabil Med 8:13–22PubMedGoogle Scholar
- 52.Javalkar K, Fenton N, Cohen S, Ferris M (2014) Socioecologic factors as predictors of readiness for self-management and transition, medication adherence, and health care utilization among adolescents and young adults with chronic kidney disease. Prev Chronic Dis 11:E117CrossRefPubMedPubMedCentralGoogle Scholar
- 54.Hattori M, Iwano M, Sako M, Honda M, Okada H, Akioka Y, Ashida A, Kawasaki Y, Kiyomoto H, Terada Y, Hirano D, Fujieda M, Fujimoto S, Masaki T, Maruyama S, Mastuo S (2016) Transition of adolescent and young adult patients with childhood-onset chronic kidney disease from pediatric to adult renal services: a nationwide survey in Japan. Clin Exp Nephrol 20:918–925CrossRefPubMedGoogle Scholar
- 61.Kreuzer M, Prufe J, Bethe D, Vogel C, Grosshennig A, Koch A, Oldhafer M, Dierks ML, Albrecht UV, Muther S, Brunkhorst R, Pape L, Study group of the German Society for Pediatric N (2014) The TRANSNephro-study examining a new transition model for post-kidney transplant adolescents and an analysis of the present health care: study protocol for a randomized controlled trial. Trials 15:505CrossRefPubMedPubMedCentralGoogle Scholar