Burden, access, and disparities in kidney disease

Deidra C Crews,Aminu K Bello,Gamal Saadi,Philip Kam Tao Li,Guillermo Garcia-Garcia,Sharon Andreoli,Deidra Crews,Kamyar Kalantar-Zadeh,Charles Kernahan,Latha Kumaraswami,Luisa Strani

doi:10.1016/j.kint.2018.11.007

Deidra C Crews, Aminu K Bello + Show 9 more

Open Access

https://doi.org/10.1016/j.kint.2018.11.007

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Journal: Kidney International	Publication Date: Jan 18, 2019
Citations: 38	License type: publisher-specific-oa

Affiliation: University of Alberta, Johns Hopkins University

Abstract

Kidney disease is a global public health problem, affecting over 750 million persons worldwide. The burden of kidney disease varies substantially across the world, as does its detection and treatment. In many settings, rates of kidney disease and the provision of its care are defined by socio-economic, cultural, and political factors leading to significant disparities. World Kidney Day 2019 offers an opportunity to raise awareness of kidney disease and highlight disparities in its burden and current state of global capacity for prevention and management. Here, we highlight that many countries still lack access to basic diagnostics, a trained nephrology workforce, universal access to primary health care, and renal replacement therapies. We point to the need for strengthening basic infrastructure for kidney care services for early detection and management of acute kidney injury and chronic kidney disease across all countries and advocate for more pragmatic approaches to providing renal replacement therapies. Achieving universal health coverage worldwide by 2030 is one of the World Health Organization's Sustainable Development Goals. While universal health coverage may not include all elements of kidney care in all countries, understanding what is feasible and important for a country or region with a focus on reducing the burden and consequences of kidney disease would be an important step toward achieving kidney health equity.

Highlights

In many settings, rates of kidney disease and the provision of its care are defined by socioeconomic, cultural, and political factors, leading to significant disparities in disease burden, even in developed countries [3]
Rates of kidney disease and the provision of its care are defined by socioeconomic, cultural, and political factors, leading to significant disparities in disease burden, even in developed countries [3]. These disparities exist across the spectrum of kidney disease—from preventive efforts to curb development of acute kidney injury (AKI) or chronic kidney disease (CKD), to screening for kidney disease among persons at Received: 19.10.2018
Whereas several countries have national data collection systems, for end-stage renal disease (ESRD) (e.g., United States Renal Data System, Latin American Dialysis and Renal Transplant Registry, and Australia and New Zealand Dialysis and Transplant Registry), high-quality data regarding nondialysis CKD is limited, and often the quality of ESRD data is quite variable across settings [5]

Summary

Introduction

Rates of kidney disease and the provision of its care are defined by socioeconomic, cultural, and political factors, leading to significant disparities in disease burden, even in developed countries [3]. In several high-income countries, universal health care is provided by the government and includes CKD and ESRD care.

Results

Conclusion