Global nephrology workforce: gaps and opportunities toward a sustainable kidney care system

Osman, Mohamed A.; Alrukhaimi, Mona; Ashuntantang, Gloria; Bellorín-Font, Ezequiel; Gharbi, Mohammed Benghanem; Braam, Branko; Courtney, Mark; Feehally, John; Harris, David C.H.; Jha, Vivekanand; Jindal, Kailash; Johnson, David W.; Kalantar-Zadeh, Kamyar; Kazancıoğlu, Rümeyza; Klarenbach, Scott; Levin, Adeera; Lunney, Meaghan; Okpechi, Ikechi G.; Olanrewaju, Timothy Olusegun; Perl, Jeffrey; Rashid, Harun Ur; Rondeau, Éric; Salako, Babatunde Lawal; Samimi, Arian; Solá, Laura; Tchokhonelidze, Irma; Wiebe, Natasha; Yang, Chih Wei; Ye, Feng; Zemchenkov, Alexander; Zhao, Ming; Bello, Aminu K.

doi:10.1016/j.kisu.2017.10.009

Cited by 148 publications

(152 citation statements)

References 42 publications

Supporting

Mentioning

141

Contrasting

Unclassified

Order By: Relevance

“…A pharmaceutical company funded a similar screening program in India. 61 Similar large community-based screening programs for CKD are sparse in Sub-Saharan Africa. Out-of-pocket expenditure for CKD screening services will most likely discourage inhabitants of the rural areas of LMICs.…”

Section: Cost Of Screening Programsmentioning

confidence: 99%

“…Globally, there is a shortage of skilled nephrology personnel, which is more acute in the developing world. 61 This shortage makes secondary and tertiary prevention programs challenging to see through as the number of persons with CKD requiring prevention of progression may overwhelm the available workforce. The various intervention programs of the International Society of Nephrology, including short-and long-term fellowships and educational ambassador programs, have helped train the different cadre of the nephrology workforce in the LMICs, but there is still a considerable gap that could be filled by long-term training programs instituted by health policy makers in various LMICs.…”

Section: Lack Of Skilled Workforcementioning

confidence: 99%

See 1 more Smart Citation

Preventing CKD in Low- and Middle-Income Countries: A Call for Urgent Action

Ameh¹,

Ekrikpo

Kengne

2020

Kidney International Reports

View full text Add to dashboard Cite

The epidemiologic transition occurring in low-and middle-income countries (LMICs) has led to a surge in chronic kidney disease (CKD) prevalence because of a combination of highly prevalent chronic noncommunicable diseases (NCDs) and communicable diseases (CDs). The progressive rise in CKD prevalence in LMICs threatens the existing weak health systems in these countries as care for advanced CKD remains largely unavailable and unaffordable. An interplay of low literacy levels, poor health-seeking behavior, inadequate health care funding, weak health systems, and lack of skilled nephrology workforce has made it difficult for adequate CKD preventive measures to be implemented. Primary, secondary, and tertiary prevention measures need to be instituted in LMICs by a collaboration of governmental and nongovernmental organizations to stem this tide and help prevent deaths from other NCDs that share similar risk factors with CKD. For these to be effective, locally relevant knowledge is needed to contextualize existing prevention and control solutions, or to develop novel and more appropriate solutions for LMICs.Kidney Int Rep (2020) 5, 255-262; https://doi.

show abstract

Section: Cost Of Screening Programsmentioning

confidence: 99%

Section: Lack Of Skilled Workforcementioning

confidence: 99%

Preventing CKD in Low- and Middle-Income Countries: A Call for Urgent Action

Ameh¹,

Ekrikpo

Kengne

2020

Kidney International Reports

View full text Add to dashboard Cite

show abstract

“…For other care providers essential for kidney care, international variations exist in distribution (availability and adequacy). Overall, provider shortages were highest for renal pathologists, vascular access coordinators, and dietitians (with 86%, 81%, and 78% of countries reporting a 4 Osman et al, 43 shortage, respectively), and the shortages were more common in low-income countries. Few countries (35%) reported a shortage in laboratory technicians.…”

Section: Organization and Structures For Kidney Disease Carementioning

confidence: 99%

Burden, access, and disparities in kidney disease

Crews

Bello

Saadi

2019

Kidney International

Self Cite

View full text Add to dashboard Cite

“…There are currently 130 registered nephrologists in SA; this is 2.3 nephrologists per million individuals, which is far lower than the global average [35]. In SA, to qualify to be trained in nephrology, the trainee is required to first have obtained a postgraduate fellowship, e.g., fellow of the College of Physicians (FCP) or equivalent in internal medicine.…”

Section: Nephrology Clinical Training In Samentioning

confidence: 99%

Nephrology in South Africa: Not Yet <b><i>ubuntu</i></b>

2019

View full text Add to dashboard Cite

Background: South Africa (SA) is an upper middle-income country with a human immunodeficiency virus (HIV) epidemic, an accelerated burden of non-communicable diseases, and a concurrent epidemic of tuberculosis. These conditions overwhelm a health system struggling under the pressure of restricted resources, including an insufficient workforce. Private practice has become more involved in the care of patients in the country but serves mainly those who are members of a Medical Aid. These Medical Aids will usually cover up to 100% of the costs for management of chronic kidney disease (CKD). Summary: There are currently 2.3 nephrologists per million individuals, which is far lower than the global average and grossly inadequate to meet the nephrology care needs in SA. Covert chronic dialysis rationing has occurred in the public sector since the 1960s. However, the lack of formality triggered the formation of explicit rationing guidelines in one province. These guidelines have been ethically endorsed but not embraced nationally. The demand for hemodialysis (HD) has led some provinces to practicing “PD-First” programs. SA remains one of only 12 countries within Africa that perform renal transplantation, and it is the only country in Africa that relies on deceased donation for the majority of its transplants. The first kidney transplant in SA took place at the University of the Witwatersrand, Johannesburg, in 1966 and the first dialysis was performed by a general practitioner working in a town close to Johannesburg in 1957. The University of Cape Town successfully pioneered the transplantation of kidneys from HIV-positive donors to positive recipients. SA was the second country in the world to form a National Kidney Foundation as well as a renal society. Nephrology training is in place and incorporates master’s and PhD programs in nephrology. Despite the numerous challenges, SA nephrologists have been among the leading researchers in nephrology from the African continent.

show abstract

Global nephrology workforce: gaps and opportunities toward a sustainable kidney care system

Cited by 148 publications

References 42 publications

Preventing CKD in Low- and Middle-Income Countries: A Call for Urgent Action

Preventing CKD in Low- and Middle-Income Countries: A Call for Urgent Action

Burden, access, and disparities in kidney disease

Nephrology in South Africa: Not Yet <b><i>ubuntu</i></b>

Contact Info

Product

Resources

About