Capacity for the management of kidney failure in the International Society of Nephrology North America and the Caribbean region: report from the 2023 ISN Global Kidney Health Atlas (ISN-GKHA)

IF 19.3 2区 医学 Q1 UROLOGY & NEPHROLOGY Kidney International Supplements Pub Date : 2024-04-01 DOI:10.1016/j.kisu.2024.01.003
Racquel Lowe-Jones , Isabelle Ethier , Lori-Ann Fisher , Michelle M.Y. Wong , Stephanie Thompson , Georges Nakhoul , Shaifali Sandal , Rahul Chanchlani , Sara N. Davison , Anukul Ghimire , Kailash Jindal , Mohamed A. Osman , Parnian Riaz , Syed Saad , Stephen M. Sozio , Somkanya Tungsanga , Alexandra Cambier , Silvia Arruebo , Aminu K. Bello , Fergus J. Caskey , Deenaz Zaidi
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Abstract

The International Society of Nephrology Global Kidney Health Atlas charts the availability and capacity of kidney care globally. In the North America and the Caribbean region, the Atlas can identify opportunities for kidney care improvement, particularly in Caribbean countries where structures for systematic data collection are lacking. In this third iteration, respondents from 12 of 18 countries from the region reported a 2-fold higher than global median prevalence of dialysis and transplantation, and a 3-fold higher than global median prevalence of dialysis centers. The peritoneal dialysis prevalence was lower than the global median, and transplantation data were missing from 6 of the 10 Caribbean countries. Government-funded payments predominated for dialysis modalities, with greater heterogeneity in transplantation payor mix. Services for chronic kidney disease, such as monitoring of anemia and blood pressure, and diagnostic capability relying on serum creatinine and urinalyses were universally available. Notable exceptions in Caribbean countries included non-calcium-based phosphate binders and kidney biopsy services. Personnel shortages were reported across the region. Kidney failure was identified as a governmental priority more commonly than was chronic kidney disease or acute kidney injury. In this generally affluent region, patients have better access to kidney replacement therapy and chronic kidney disease–related services than in much of the world. Yet clear heterogeneity exists, especially among the Caribbean countries struggling with dialysis and personnel capacity. Important steps to improve kidney care in the region include increased emphasis on preventive care, a focus on home-based modalities and transplantation, and solutions to train and retain specialized allied health professionals.

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国际肾脏病学会北美和加勒比地区肾衰竭管理能力:2023 年国际肾脏病学会全球肾脏健康图集(ISN-GKHA)报告
国际肾脏病学会全球肾脏健康地图集》记录了全球肾脏保健的可用性和能力。在北美和加勒比海地区,该地图集可以发现改善肾脏保健的机会,尤其是在缺乏系统数据收集结构的加勒比海国家。在第三次迭代中,该地区 18 个国家中有 12 个国家的受访者报告称,透析和移植的普及率比全球中位数高出 2 倍,透析中心的普及率比全球中位数高出 3 倍。腹膜透析的普及率低于全球中位数,10 个加勒比海国家中有 6 个缺少移植数据。政府资助的透析方式占主导地位,而移植支付方组合的异质性更大。慢性肾脏病服务,如贫血和血压监测,以及依靠血清肌酐和尿液分析的诊断能力,是普遍提供的。加勒比国家的明显例外包括非钙基磷酸盐结合剂和肾活检服务。据报告,整个地区都存在人员短缺问题。与慢性肾病或急性肾损伤相比,肾衰竭更常被认为是政府优先考虑的问题。在这个普遍富裕的地区,患者获得肾脏替代疗法和慢性肾脏病相关服务的机会比世界上许多地方都要多。然而,加勒比地区各国的情况明显不同,尤其是在透析和人员能力方面。改善该地区肾脏护理的重要步骤包括:更加重视预防性护理,注重家庭模式和移植,以及培训和留住专业专职医疗人员的解决方案。
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来源期刊
Kidney International Supplements
Kidney International Supplements UROLOGY & NEPHROLOGY-
CiteScore
11.80
自引率
0.00%
发文量
13
期刊介绍: Kidney International Supplements is published on behalf of the International Society of Nephrology (ISN) and comes complimentary as part of a subscription to Kidney International. Kidney International Supplements is a peer-reviewed journal whose focus is sponsored, topical content of interest to the nephrology community.
期刊最新文献
Editorial Board Table of Contents Variations in kidney care management and access: regional assessments of the 2023 International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA) Update on variability in organization and structures of kidney care across world regions Capacity for the management of kidney failure in the International Society of Nephrology Newly Independent States and Russia region: report from the 2023 ISN Global Kidney Health Atlas (ISN-GKHA)
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