Status of care for end stage kidney disease in countries and regions worldwide: international cross sectional survey

作者：Aminu K. Bello, Adeera Levin, Meaghan Lunney, Mohamed A. Osman, Ye Feng, Gloria Ashuntantang, Ezequiel Bellorín-Font, Mohammed Benghanem Gharbi, Sara N. Davison, Mohammad Ghnaimat, Paul Harden, Htay Htay, Vivekanand Jha, Kamyar Kalantar‐Zadeh, Peter G. Kerr, Scott Klarenbach, Csaba P. Kövesdy, Valérie A. Luyckx, Brendon L. Neuen, Dónal O’Donoghue, Shahrzad Ossareh, Jeffrey Perl, Harun Ur Rashid, Éric Rondeau, Emily See, Syed Saad, Laura Solá, Irma Tchokhonelidze, Vladimı́r Tesař, Kriang Tungsanga, Rümeyza Kazancıoğlu, Angela Yee‐Moon Wang, Natasha Wiebe, Chih‐Wei Yang, Alexander Zemchenkov, Ming‐Hui Zhao, Kitty J. Jager, Fergus Caskey, Vlado Perkovic, Kailash Jindal, Ikechi G. Okpechi, Marcello Tonelli, John Feehally, David C.H. Harris, David W. Johnson · 发表于：BMJ · 年份：2019 · DOI：10.1136/bmj.l5873 · 被引用次数：282 · 研究领域：Dialysis and Renal Disease Management、Chronic Kidney Disease and Diabetes、Organ Donation and Transplantation

OBJECTIVE: To determine the global capacity (availability, accessibility, quality, and affordability) to deliver kidney replacement therapy (dialysis and transplantation) and conservative kidney management. DESIGN: International cross sectional survey. SETTING: International Society of Nephrology (ISN) survey of 182 countries from July to September 2018. PARTICIPANTS: Key stakeholders identified by ISN's national and regional leaders. MAIN OUTCOME MEASURES: Markers of national capacity to deliver core components of kidney replacement therapy and conservative kidney management. RESULTS: Responses were received from 160 (87.9%) of 182 countries, comprising 97.8% (7338.5 million of 7501.3 million) of the world's population. A wide variation was found in capacity and structures for kidney replacement therapy and conservative kidney management-namely, funding mechanisms, health workforce, service delivery, and available technologies. Information on the prevalence of treated end stage kidney disease was available in 91 (42%) of 218 countries worldwide. Estimates varied more than 800-fold from 4 to 3392 per million population. Rwanda was the only low income country to report data on the prevalence of treated disease; 5 (<10%) of 53 African countries reported these data. Of 159 countries, 102 (64%) provided public funding for kidney replacement therapy. Sixty eight (43%) of 159 countries charged no fees at the point of care delivery and 34 (21%) made some charge. Haemodialysis was re...