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The main objective of the eight-year ISN Sister Renal Centers (SRC) partnership was to improve the quality of pediatric kidney care at the Research & Clinical Institute for Pediatrics (RCIP), Pirogov Russian National Research Medical University, in Moscow, Russia, with support from the University Hospital (UZ) Leuven and Catholic (KU) Leuven University in Leuven, Belgium.

Find out more about the launch of this partnership here

Transformative training and knowledge exchange

To this end, five doctors, including four pediatric nephrologists and one renal dietitian, from the RCIP, visited the UZ in Leuven, and six experts from the UZ and KU Leuven, including three pediatric nephrologists, two geneticists, and one renal dietitian visited the RCIP. These exchanges helped significantly improve the quality of early diagnosis and treatment of kidney diseases in children at the center.

Professor Elena Levtchenko (with bouquet), head of the KU pediatric unit, with Professor Larisa Prikhodina (third from right) and staff from the RCIP at a scientific meeting held as part of ISN SRC activities

The emerging center in Moscow organized five annual training courses in pediatric nephrology throughout the ISN-SRC partnership, which featured 11 experts from the UK, the USA, and Europe, with six speakers from the UZ Leuven in Belgium. These events were attended by nearly 600 people in person and over 250 online.

During the program, three doctors from the emerging center received certificates in the first level of the International Pediatric Nephrology Association – European Society for Paediatric Nephrology Master Junior Classes in Pediatric Nephrology. One trainee is currently enrolled in these classes.

Improved treatment practices and research initiatives

With guidance from doctors at UZ and KU Leuven, a multidisciplinary kidney care team was created at the institute in Moscow. The team includes pediatric nephrologists, urologists, pediatric surgeons, an orthopedic surgeon, endocrinologists, a renal dietitian, and an expert in clinical and molecular genetics, enabling the institute to offer high-quality kidney care to children.

The team at RCIP has also improved their knowledge and skills in preventing calcineurin inhibitor nephrotoxicity in children with steroid-resistant nephrotic syndrome, established a clinical and genetic program for children with nephrocalcinosis, and developed the first national clinical practical recommendations for the management of nephrotic syndrome in children.

Previously, no children with steroid-dependent and frequently relapsed nephrotic syndrome were treated with rituximab. The center now offers this treatment to 32 younger patients. RNAi therapy for primary hyperoxaluria type 1 and burosumab treatment for X-linked hypophosphatemia were introduced into clinical practice in 2021 through the Circle of Kindness charity.

Dr. Svetlana Papizh (left), leading researcher and pediatric nephrologist at KU Leuven, alongside Professor Levtchenko during her visit to the RCIP

In addition, the center now implements international guidelines, clinical practice recommendations, and standard operating procedures. The teams in Moscow collaborated to set up 14 registries on kidney diseases in children, which have been included in international registries. The pediatric kidney care team at the RCIP is involved in global research projects in pediatric nephrology, resulting in 30 publications in international peer-reviewed journals.

The teams also worked together to establish a nephrogenetics reference center, which provides free next-generation sequencing for all children with steroid-resistant nephrotic syndrome, tubulopathies, and chronic kidney disease of unknown etiology.

Measuring progress

Significant advancements have been achieved at the hospital through the ISN SRC Program: The center’s capacity to treat children with kidney diseases increased from 765 in 2016 to 929 in 2023, while the average length of hospitalization for these patients decreased from 17 days in 2016 to 9 days in 2023.

Keen to share knowledge and experience and expand advances in pediatric care further afield, the two centers plan to form an SRC trio partnership with an institution in Kyrgyzstan. Emma Children’s Hospital in Amsterdam, where Dr. Levtchenko now works, will serve as the mentor center.

Dr. Anna Khohlovajunior researcher and pediatric nephrologist at the RCIP, presented her abstract at WCN’23

ISN SRC liaison officer from the emerging center, Professor Larisa Prikhodina, commented, “The whole team is very grateful to the ISN for creating a unique system for improving kidney care in children. We have made tremendous progress and provided high-quality management of pediatric patients with inherited and acquired kidney disorders. We hope to remain members of the ISN family for a long time and plan to participate in many ISN programs and activities.”