SAT-304 Availability, accessibility, and quality of conservative kidney management worldwide: a substudy of the Global Kidney Health Atlas

Abstract

People with end-stage kidney disease (ESKD) typically receive kidney replacement therapy (KRT) in the form of dialysis or transplantation. However, studies have suggested that not all patients with ESKD are best suited for KRT. Additionally, KRT is costly and not always accessible in resource-restricted settings. Conservative kidney management (CKM) is an alternate ESKD therapy, which focuses on symptom management, psychological health, and family and social support. Despite its importance in ESKD care, several barriers exist that impact the uptake or quality of CKM. The Global Kidney Health Atlas (GKHA) is an ongoing initiative of the International Society of Nephrology (ISN), which aims to monitor and evaluate the status of global kidney care worldwide. This study reports on findings from the 2018 GKHA survey, specifically addressing the availability, accessibility, and quality of CKM. Respondents from 160 countries completed the survey and 154 answered questions pertaining to CKM. Of these, 124 (81%) stated that CKM was available. Several gaps were reported across most quality indicators, particularly in low-income countries. Overall, CKM is available in most countries; however, is not optimally accessible or of highest quality. Efforts to increase the awareness and adoption of practices recommended for CKM are needed to ensure high quality of care.