TY - JOUR
T1 - Burden, access, and disparities in kidney disease
AU - World Kidney Day Steering Committee
AU - Crews, D. C.
AU - Bello, A. K.
AU - Saadi, G.
N1 - Funding Information:
The appropriate number of nephrologists in a country depends on many factors, including need, priority, and resources, and as such, there is no global standard with respect to nephrologist density. Regardless, the demonstrated low density in low-income countries calls for concern as nephrologists are essential to provide leadership in kidney disease care, and a lack of nephrologists may result in adverse consequences for policy and practice. However, it is quite encouraging that the number of nephrologists and nephropathologists is rising in low-income and lower-middle-income countries, in part thanks to fellowship programs supported by international nephrology organizations (45). It is important to note that the role of a nephrologist may differ depending on how the health care system is structured. The density statistic merely represents the number of nephrologists per million population and provides no indication of the adequacy to meet the needs of the population or quality of care, which depends on volume of patients with kidney disease and other workforce support (e.g., availability of multidisciplinary teams).
Publisher Copyright:
© 2019, Associacao Brasileira de Divulgacao Cientifica. All rights reserved.
PY - 2019
Y1 - 2019
N2 - 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 towards achieving kidney health equity.
AB - 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 towards achieving kidney health equity.
KW - Acute kidney injury
KW - End stage renal disease
KW - Global health
KW - Health equity
KW - Social determinants of health
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U2 - 10.1590/1414-431x20198338
DO - 10.1590/1414-431x20198338
M3 - Article
C2 - 30916222
AN - SCOPUS:85063950850
SN - 0100-879X
VL - 52
JO - Brazilian Journal of Medical and Biological Research
JF - Brazilian Journal of Medical and Biological Research
IS - 3
M1 - e8338
ER -