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2019

ANUÁRIO DO HOSPITAL
DONA ESTEFÂNIA

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The transition from pediatric to adult services.

Marina Vieira1, Cecília Silva1, Margarida Abranches2

1 - Nephrology Department, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Lisboa, Portugal.
2 - Pediatric Nephrology Unit, Hospital Dona Estefânea, Centro Hospitalar Lisboa Central, Lisboa, Portugal.

- Port J Nephrol Hypert 2018; 32(4): 393-394. (artigo)

Resumo: Pediatric nephrology diagnoses have specific characteristics, often not well known in the adult nephrological world. The timing of the transfer from pediatric to adult services is a critical phase with an increased morbidity and mortality, requiring prior preparation, making it necessary to define the optimal transitional phase during which the young patient is progressively empowered with the skills and knowledge needed for a future management of his healthcare in an adult environment. This transitional and transfer process is made more difficult by the differences between the care provided to the pediatric versus the adult patient. In 2015, the nephrology department of Curry Cabral Hospital and the Pediatric Nephrology Unit of Dona Estefânia Hospital developed a collaborative strategy for nephrological transition and transfer. The multiple difficulties found in the nephrological transition phase and consequently in the effective transfer of the patient have led International Societies to draw up recommendations to facilitate this process. Our implemented strategy comprised a transition phase with joint consultations with both pediatric and adult nephrologist. These took place in the pediatric department. Effective transfer to adult care services took place only when the young patients had sufficient empowerment and knowledge to understand the importance of taking care of their own health in adult services. Thirty-three patients (22 males and 11 females) were evaluated and transferred from 01/05/2015 to 31/07/2018. A total of 111 appointments were performed. Of the 33 patients transferred, only one dropped out, representing a compliance of 96.9%. Unfortunately, one patient diagnosed with lupus nephritis stopped taking medication after the nephrological transfer phase and started hemodialysis. Patients’ diagnoses are described in Table I. The group of Congenital Anomalies of Kidney and Urinary Tract (CAKUT) represents 63.6% of the diagnosis. CAKUT causes 30-50% of end stage renal disease. The ideal is to create a nephrology transition program based on international recommendations and adapted to the reality of each hospital. To ensure a good continuity of care, it is essential that the adult nephrologist is aware of the diseases that most frequently cause renal failure in the pediatric age range.

Palavras Chave: pediatric nephrology, transition, adult care.