Hemodialysis access in Guatemalan children: a story of global health and the power of philanthropy

International Pediatric Nephrology Association | November 2, 2024 | PDF

It is well appreciated that vascular access is the Achilles heel to successful hemodialysis. This is particularly true in pediatric dialysis, where the difficulties in establishing good vascular access are exacerbated by the small patient size and the limited number of surgeons who place arteriovenous fistulas (AVF) in children. We therefore read with great interest the study by Jennings et al., which reports on the success of a collaborative philanthropic effort between pediatric nephrologists and surgeons in Guatemala and the USA to establish a pediatric autogenous vascular access teaching program to place AVF in children on hemodialysis in Guatemala [1]. The program was hugely successful with153 AVF procedures completed over an 8-year period. We thought that it would be of interest to the pediatric nephrology community to provide more background on how this international collaboration developed and explore what lessons could be applied to improve global health in moderate-to low-resource areas and even in high-resource areas such as the USA and Europe.