A child holding a kidney-shaped balloon with a healthcare team.

Navigating Palliative Care in Pediatric Nephrology: Why Compassionate Support Matters

Kai Mendoza in Health & Wellness November 2025 • 4 min read.

"A crucial look at the current state of palliative care for children with kidney disease and how a multidisciplinary approach can improve their quality of life."

Chronic kidney disease (CKD) in children presents unique challenges, demanding a comprehensive approach that extends beyond medical treatment. While advancements have improved survival rates, the impact on quality of life remains a significant concern. Frequent hospitalizations, exhaustive therapies, and side effects can severely impair the well-being of young patients.

Palliative care offers a holistic solution, focusing on alleviating suffering and improving the overall quality of life for children and their families. It's not just about end-of-life care; it's about providing support from the moment of diagnosis, addressing physical, emotional, social, and spiritual needs.

A recent survey sheds light on the current state of palliative care structures within pediatric nephrology in Germany. It highlights the perspectives of a multidisciplinary healthcare team, including physicians, nurses, and psychosocial health professionals, revealing both the potential and the limitations of current practices.

What are the Key Findings of the Palliative Care Survey?

A child holding a kidney-shaped balloon with a healthcare team.

The survey, conducted among members of the German Society of Nephrology and nurse managers of pediatric dialysis centers, revealed a significant gap in palliative care integration. While most respondents recognized the importance of palliative care, the existing structures were deemed insufficient.

Here's a breakdown of the key findings:

Limited Availability: Only a small percentage of centers have specialized palliative care services.
Desire for Training: A significant majority of healthcare professionals expressed a desire for further training in palliative care.
Multidisciplinary Support: The survey emphasized the need for a team-based approach, involving physicians, nurses, and psychosocial health professionals.
Responsibility Confusion: There was a lack of clarity regarding who should be primarily responsible for providing palliative care.
Barriers to Integration: Key obstacles included a lack of expertise, inadequate funding, and a shortage of specialized care teams.

These findings underscore the urgent need to improve palliative care structures within pediatric nephrology to better support children and families facing CKD.

The Path Forward: Integrating Compassionate Care into Pediatric Nephrology

The survey's conclusions point to a clear need for action. Integrating palliative care into routine treatment for children with CKD requires a multi-pronged approach. This includes increasing access to specialized palliative care teams, providing comprehensive training for healthcare professionals, and securing adequate funding for these essential services. By prioritizing compassionate care, we can significantly improve the lives of children and adolescents living with kidney disease, ensuring they receive the support and comfort they deserve.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1111/apa.14688, Alternate LINK

Title: A Survey Demonstrates Limited Palliative Care Structures In Paediatric Nephrology From The Perspective Of A Multidisciplinary Healthcare Team

Subject: General Medicine

Journal: Acta Paediatrica

Publisher: Wiley

Authors: Julia Thumfart, Dirk Bethe, Sarah Wagner, Wolfgang Pommer, Cornelia Rheinländer, Dominik Müller

Published: 2019-01-10

Everything You Need To Know

What is the primary goal of palliative care when applied to pediatric nephrology?

Palliative care in pediatric nephrology focuses on improving the quality of life for children and their families facing chronic kidney disease (CKD). It addresses physical, emotional, social, and spiritual needs from the point of diagnosis, not just at the end of life. It aims to alleviate suffering caused by frequent hospitalizations, intensive therapies, and side effects, offering a holistic approach to care that complements medical treatment.

What were the main shortcomings identified by the palliative care survey within pediatric nephrology?

The survey conducted among members of the German Society of Nephrology and nurse managers in pediatric dialysis centers revealed significant gaps in palliative care integration. Key findings included limited availability of specialized palliative care services, a desire among healthcare professionals for further training in palliative care, the necessity of a multidisciplinary approach, confusion regarding responsibility for providing palliative care, and barriers such as a lack of expertise, inadequate funding, and a shortage of specialized care teams.

What are the essential steps to integrate compassionate care into the routine treatment of children with chronic kidney disease?

Integrating compassionate care into pediatric nephrology involves several steps. It requires increasing access to specialized palliative care teams, providing comprehensive training for healthcare professionals in palliative care, and securing adequate funding for these essential services. This multi-pronged approach aims to ensure children and adolescents with CKD receive the support and comfort they deserve, enhancing their quality of life alongside medical treatment.

Who should be included in a multidisciplinary healthcare team to provide optimal palliative care in pediatric nephrology, as suggested by the survey?

A multidisciplinary healthcare team in pediatric nephrology palliative care ideally includes physicians, nurses, and psychosocial health professionals. The German survey emphasized that a team-based approach is vital for effective palliative care, addressing the various needs of young patients and their families. By bringing together different areas of expertise, the team can provide comprehensive support.

How can hospitals address the issue of unclear responsibility for providing palliative care in pediatric nephrology settings?

Addressing the lack of clarity regarding responsibility for palliative care in pediatric nephrology involves defining clear roles and responsibilities within healthcare teams. Institutions need to ensure that a designated team or individual is responsible for initiating and coordinating palliative care services. The survey indicates a need for a structured approach to ensure that palliative care is not overlooked and that all members of the healthcare team understand their roles in providing compassionate support.