The second Global Kidney Health Summit outputs: developing a strategic plan to increase access to integrated end-stage kidney disease care worldwide

Harris, David C.H.; Davies, Simon; Finkelstein, Fredric O.; Jha, Vivekanand

doi:10.1016/j.kisu.2019.09.001

Cited by 10 publications

(10 citation statements)

References 13 publications

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“…Majority of SA and SEA countries are LME and LE, where access to healthcare is a big challenge particularly kidney care; the region harbors a huge burden of ∼188 million patients with ESKD [ 43 ]. There is an evident mismatch between the need and supply of RRT in the LE and LME countries, resulting in inadequate patient care and increased mortality [ 43 , 44 ]. Despite efforts from governments and nephrology societies to bring down the disparity in demand and supply of RRT, the situation is far from ideal.…”

Section: Discussionmentioning

confidence: 99%

Impact of National Economy and Policies on End-Stage Kidney Care in South Asia and Southeast Asia

Schmeißer

Jasuja

Gallieni

et al. 2021

International Journal of Nephrology

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Background. The association between economic status and kidney disease is incompletely explored even in countries with higher economy (HE); the situation is complex in lower economies (LE) of South Asia and Southeast Asia (SA and SEA). Methods. Fifteen countries of SA and SEA categorized as HE and LE, represented by the representatives of the national nephrology societies, participated in this questionnaire and interview-based assessment of the impact of economic status on renal care. Results. Average incidence and prevalence of end-stage kidney disease (ESKD) per million population (pmp) are 1.8 times and 3.3 times higher in HE. Hemodialysis is the main renal replacement therapy (RRT) (HE-68%, LE-63%). Funding of dialysis in HE is mainly by state (65%) or insurance bodies (30%); out of pocket expenses (OOPE) are high in LE (41%). Highest cost for hemodialysis is in Brunei and Singapore, and lowest in Myanmar and Nepal. Median number of dialysis machines/1000 ESKD population is 110 in HE and 53 in LE. Average number of machines/dialysis units in HE is 2.7 times higher than LE. The HE countries have 9 times more dialysis centers pmp (median HE-17, LE-02) and 16 times more nephrologist density (median HE-14.8 ppm, LE-0.94 ppm). Dialysis sessions >2/week is frequently followed in HE (84%) and <2/week in LE (64%). “On-demand” hemodialysis (<2 sessions/week) is prevalent in LE. Hemodialysis dropout rates at one year are lower in HE (12.3%; LE 53.4%), death being the major cause (HE-93.6%; LE-43.8%); renal transplants constitute 4% (Brunei) to 39% (Hong Kong) of the RRT in HE. ESKD burden is expected to increase >10% in all the HE countries except Taiwan, 10%–20% in the majority of LE countries. Conclusion. Economic disparity in SA and SEA is reflected by poor dialysis infrastructure and penetration, inadequate manpower, higher OOPE, higher dialysis dropout rates, and lesser renal transplantations in LE countries. Utility of RRT can be improved by state funding and better insurance coverage.

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Section: Discussionmentioning

confidence: 99%

Impact of National Economy and Policies on End-Stage Kidney Care in South Asia and Southeast Asia

Schmeißer

Jasuja

Gallieni

et al. 2021

International Journal of Nephrology

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“…The decision to KRT modality should be individualized in a timely shared decision‐making process with unbiased information on KRT options to ensure a timely dialysis access preparation and avoid unplanned dialysis initiation 28,30 . Despite universal coverage, the residual financial burden remained high in dialysis patients.…”

Section: Barriers and Constraints Of The Reformed Dialysis Policy And...mentioning

confidence: 99%

Dialysis and kidney transplant practices and challenges in Thailand

et al. 2023

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“…In much of the developing world, transplantation or other treatment such as dialysis is largely unavailable due to financial constraints, and kidney failure is a death sentence ( 1 – 4 ). In the developed world, many people struggle on dialysis, a temporary treatment, while enduring long waits for transplantation, with many thousands dying each year while waiting due to the shortage of transplantable organs.…”

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confidence: 99%

“… §§ Harris et al ( 3 ) write: “It is estimated that the number of people dying globally with ESRD for want of kidney replacement therapy is up to 3 times the number who receive it. Kidney transplantation meets only a small fraction of the therapeutic need.…”

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Global kidney chains

Nikzad

Akbarpour

Rees

et al. 2021

Proc. Natl. Acad. Sci. U.S.A.

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Kidney failure is a worldwide scourge, made more lethal by the shortage of transplants. We propose a way to organize kidney exchange chains internationally between middle-income countries with financial barriers to transplantation and high-income countries with many hard to match patients and patient–donor pairs facing lengthy dialysis. The proposal involves chains of exchange that begin in the middle-income country and end in the high-income country. We also propose a way of financing such chains using savings to US health care payers.

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The second Global Kidney Health Summit outputs: developing a strategic plan to increase access to integrated end-stage kidney disease care worldwide

Cited by 10 publications

References 13 publications

Impact of National Economy and Policies on End-Stage Kidney Care in South Asia and Southeast Asia

Impact of National Economy and Policies on End-Stage Kidney Care in South Asia and Southeast Asia

Dialysis and kidney transplant practices and challenges in Thailand

Global kidney chains

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