djamila-djahida batouche

Background: Pediatric kidney failure, whether acute or chronic, constitutes a major public

health issue because of its impact on survival, linear growth, neurocognitive development,

and long-term quality of life. While high-income countries have markedly improved outcomes

through early diagnosis, advanced dialysis technologies, and kidney transplantation,

management remains limited in low- and middle-income countries, particularly in the

Maghreb region. Objective: This review aims to provide an updated synthesis of pediatric

kidney failure, with emphasis on renal replacement therapy modalities and the specific

challenges encountered in resource-limited contexts, particularly in Algeria. Methods and

Content: We successively address the pathophysiological and clinical bases of pediatric

acute kidney injury and chronic kidney disease, followed by a discussion of available

therapeutic strategies: peritoneal dialysis, intermittent hemodialysis, continuous renal

replacement therapy, and pediatric kidney transplantation. Particular attention is given

to organizational constraints, actual availability of modalities, limited access to consumables

and immunosuppressive therapies, and the specificities of pediatric kidney care in

the Maghreb region in comparison with international recommendations. Perspectives:

Improving outcomes for children with kidney failure in Maghreb countries requires a

multidimensional approach integrating early screening, strengthening peritoneal dialysis

programs, structured development of pediatric kidney transplantation, and enhanced

regional and international collaboration. Reinforcing local research capacity and participation

in international registries are essential steps toward reducing disparities in care and

adapting global guidelines to local realities.

Keywords: pediatric acute kidney injury; chronic kidney disease; renal replacement

therapy; peritoneal dialysis; continuous renal replacement therapy; pediatric kidney

transplantation; resource-limited settings; Maghreb; Algeria; health disparities