BACKGROUND: The application of international recommendations for paediatric maintenance haemodialysis (HD) could be strengthened by national laws or written recommendations. Our aim was therefore to describe the national rules governing paediatric maintenance HD in European countries. METHODS: A national representative, approved by the president of each paediatric nephrology society, was contacted in all 42 European countries to complete two online questionnaires. RESULTS: Answers were received from 36 countries. The population served by HD centres varies from 83,000 to 1,197,000 residents below 18 years of age and the estimated mean number of children on HD per centre from 0.2 to 13.5. The lowest age at which a child can be dialysed in an adult centre varies from 0 to 18 years. Laws or written national recommendations specifying: this age, the need for a paediatrician as part of medical team in mixed adult-paediatric centres, the minimum number of doctors per centre and the number of patients per nurse or nurse's aide required during sessions exist in only 25, 22, 22, 44 and 8% of the countries, respectively. Similarly, dietitians, social workers, school service, psychologists and play specialists/youth workers are required by law or written national recommendations in 36, 28, 36, 31 and 14% of countries, respectively. CONCLUSION: Laws or written national recommendations for paediatric maintenance HD are rare in European countries and very heterogeneous when they exist. This calls for discussion among paediatric and adult nephrologists and health authorities on the organisation of safe and effective paediatric HD practices.

• Keywords
• Child, Legal status, Maintenance haemodialysis, Recommendations, Survey,
• MeSH
• Kidney Failure, Chronic * therapy   MeSH
• Renal Dialysis * standards   MeSH
• Child MeSH
• Infant MeSH
• Humans MeSH
• Adolescent MeSH
• Nephrology legislation & jurisprudence   MeSH
• Infant, Newborn MeSH
• Pediatrics * legislation & jurisprudence   standards   MeSH
• Child, Preschool MeSH
• Surveys and Questionnaires MeSH
• Practice Guidelines as Topic MeSH
• Check Tag
• Child MeSH
• Infant MeSH
• Humans MeSH
• Adolescent MeSH
• Infant, Newborn MeSH
• Child, Preschool MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Europe MeSH

The strengths and the limitations of research activities currently present in Europe are explored in order to outline how to proceed in the near future. Epidemiological and clinical research and public policy in Europe are generally considered to be comprehensive and successful, and the European Renal Association - European Dialysis and Transplant Association (ERA-EDTA) is playing a key role in the field of nephrology research. The Nephrology and Public Policy Committee (NPPC) aims to improve the current situation and translation into public policy by planning eight research topics to be supported in the coming 5 years by ERA-EDTA.

• Keywords
• acute kidney injury, big data, cohorts, guidelines, registry,
• MeSH
• Biomedical Research standards   MeSH
• Renal Dialysis standards   MeSH
• Child MeSH
• Adult MeSH
• Cooperative Behavior * MeSH
• Humans MeSH
• Nephrology organization & administration   MeSH
• Registries MeSH
• Societies, Medical * MeSH
• Kidney Transplantation standards   MeSH
• Public Policy * MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Humans MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Europe MeSH