Challenges in managing end stage kidney disease in children:
The present case has been reported in the Asian Journal of Pediatric Nephrology. Treatment of children with end-stage kidney disease (ESKD) poses various challenges. While these have been studied extensively in affluent countries, data from developing regions are scant.

In most rich countries, state-of-art management and financial and social support are provided by the government or available through insurance, and prognosis for even young children is improving.

In contrast, most low-income countries, either lack in facilities for renal replacement or these are not afforded by the vast majority, and a large number of patients succumb for lack of treatment.

In rare settings where such treatment is provided free of cost, the inability to meet costs of related expenses such as transport and accommodation result in families discontinuing management for most patients. Studies should define the extent and determinants of these concerns for children with ESKD in developing countries.

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