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
{"title":"Considerations on equity in management of end-stage kidney disease in low- and middle-income countries","authors":"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","doi":"10.1016/j.kisu.2019.11.004","DOIUrl":null,"url":null,"abstract":"<div><p><span>Achievement of equity in health requires development of a health system<span> 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<span> (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<span> spending, funding and delivery models, and nature of KRT prioritization (transplantation, hemodialysis or </span></span></span></span>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.</p></div>","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":null,"pages":null},"PeriodicalIF":19.3000,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.kisu.2019.11.004","citationCount":"21","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Kidney International Supplements","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2157171619300188","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
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.
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.