Abstract
The increased burden of CKD in disadvantaged populations is due to both global factors and population-specific issues. Low socioeconomic status and poor access to care contribute to health care disparities, and exacerbate the negative effects of genetic or biologic predisposition. Provision of appropriate renal care to these populations requires a two-pronged approach: expanding the reach of dialysis through development of low-cost alternatives that can be practiced in remote locations, and implementation and evaluation of cost-effective prevention strategies. Kidney transplantation should be promoted by expanding deceased donor transplant programs and use of inexpensive, generic immunosuppressive drugs. The message of WKD 2015 is that a concerted attack against the diseases that lead to ESRD, by increasing community outreach, better education, improved economic opportunity, and access to preventive medicine for those at highest risk, could end the unacceptable relationship between CKD and disadvantage in these communities. Resume On attribue l’accroissement du fardeau maladie renale des populations defavorisees a certains facteurs mondiaux et a des enjeux specifiques de ces populations donnees. Un statut socioeconomique faible et une accessibilite aux soins de sante deficiente sont des facteurs qui contribuent aux disparites des soins de sante, et qui aggravent les predispositions genetiques ou biologiques. L’approvisionnement des populations defavorisees en soins renaux adequats necessite une approche a deux volets : il faut etendre la portee des soins d’hemodialyse par le biais du developpement d’initiatives a faible cout pouvant etre realisees en region eloignee, d’une part, et implementer et evaluer, d’autre part, des strategies rentables de prevention. La promotion de la transplantation renale devrait s’effectuer par le developpement des programmes de transplantations provenant de personnes decedees, et par l’utilisation de medicaments immunosuppresseurs generiques moins couteux. Le message de la journee mondiale du rein de 2015 est qu’une collaboration accrue des differents professionnels dans le combat des maladies pouvant mener au stade terminal de la maladie renale pourrait mettre un frein a la relation inacceptable qui perdure entre la maladie renale chronique et les populations defavorisees, et ce, en augmentant les activites de sensibilisation au sein de ses populations et les chances de developpement economique, en ameliorant la qualite de l’education, et en permettant l’acces aux medicaments de prevention.
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