Considerations on equity in management of end-stage kidney disease in low- and middle-income countries

IF 19.3 2区 医学 Q1 UROLOGY & NEPHROLOGY Kidney International Supplements Pub Date : 2020-03-01 DOI:10.1016/j.kisu.2019.11.004
Wim Van Biesen , Vivekanand Jha , Ali K. Abu-Alfa , Sharon P. Andreoli , Gloria Ashuntantang , Bassam Bernieh , Edwina Brown , Yuqing Chen , Rosanna Coppo , Cecile Couchoud , Brett Cullis , Walter Douthat , Felicia U. Eke , Brenda Hemmelgarn , Fan Fan Hou , Nathan W. Levin , Valerie A. Luyckx , Rachael L. Morton , Mohammed Rafique Moosa , Fliss E.M. Murtagh , Guillermo Garcia Garcia
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引用次数: 21

Abstract

Achievement of equity in health requires development of a health system in which everyone has a fair opportunity to attain their full health potential. The current, large country-level variation in the reported incidence and prevalence of treated end-stage kidney disease indicates the existence of system-level inequities. Equitable implementation of kidney replacement therapy (KRT) programs must address issues of availability, affordability, and acceptability. The major structural factors that impact equity in KRT in different countries are the organization of health systems, overall health care spending, funding and delivery models, and nature of KRT prioritization (transplantation, hemodialysis or peritoneal dialysis, and conservative care). Implementation of KRT programs has the potential to exacerbate inequity unless equity is deliberately addressed. In this review, we summarize discussions on equitable provision of KRT in low- and middle-income countries and suggest areas for future research.

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低收入和中等收入国家对终末期肾病管理公平性的考虑
实现卫生公平需要发展一个人人都有公平机会充分发挥其健康潜力的卫生系统。目前,报告的终末期肾病的发病率和流行率在国家层面上存在很大差异,这表明存在系统层面的不平等。肾脏替代疗法(KRT)项目的公平实施必须解决可获得性、可负担性和可接受性等问题。影响不同国家KRT公平性的主要结构性因素是卫生系统的组织、总体卫生保健支出、资金和提供模式,以及KRT优先次序的性质(移植、血液透析或腹膜透析和保守护理)。除非有意解决公平问题,否则实施KRT计划有可能加剧不平等。在这篇综述中,我们总结了在低收入和中等收入国家公平提供KRT的讨论,并提出了未来研究的领域。
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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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