75 - Global Challenges and Initiatives in Kidney Health

Abstract

The true global burden of both acute and chronic kidney disease is not known because of persistent lack of awareness and access to diagnosis in many regions. Kidney disease risk spans the continuum of human conditions, ranging from poverty to affluence overnutrition to undernutrition, fetal life to old age, conventional to traditional medicine, communicable to noncommunicable diseases, rural to industrialized societies, and from health policy to public heath to the bedside. Population aging, growing inequities, demographic transitions, and environmental threats all contribute to the growing global burden of kidney disease. Initiatives such as the Global Burden of Disease study have been raising awareness that many people worldwide are living with and dying from kidney disease. The Global Kidney Health Atlas highlights persistent inequities in resources required to tackle the burden of kidney disease across the globe. Many countries still lack access to basic diagnostics, a trained nephrology workforce, and universal access to primary health care. Access to dialysis and transplantation is highly inequitable, often requiring prohibitive out-of-pocket expenditures in lower income regions. Global initiatives such as Saving Young Lives aim to reduce unnecessary deaths from acute kidney injury through education, training, and provision of acute peritoneal dialysis. Countries such as Thailand have developed health technology assessment tools to facilitate policy development around the provision of chronic dialysis. Increasing advocacy activities and progress toward the Sustainable Development Goals, by tackling the root causes of inequity and ill health, promise future improvements in global kidney health.