International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in North America and the Caribbean

IF 19.3 2区 医学 Q1 UROLOGY & NEPHROLOGY Kidney International Supplements Pub Date : 2021-05-01 DOI:10.1016/j.kisu.2021.01.001
Aminu K. Bello , Mark McIsaac , Ikechi G. Okpechi , David W. Johnson , Vivekanand Jha , David C.H. Harris , Syed Saad , Deenaz Zaidi , Mohamed A. Osman , Feng Ye , Meaghan Lunney , Kailash Jindal , Scott Klarenbach , Kamyar Kalantar-Zadeh , Csaba P. Kovesdy , Rulan S. Parekh , Bhanu Prasad , Maryam Khan , Parnian Riaz , Marcello Tonelli , Adeera Levin
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引用次数: 2

Abstract

The International Society of Nephrology established the Global Kidney Health Atlas project to define the global capacity for kidney replacement therapy and conservative kidney care, and this second iteration was to describe the availability, accessibility, quality, and affordability of kidney failure (KF) care worldwide. This report presents results for the International Society of Nephrology North America and the Caribbean region. Relative to other regions, the North America and Caribbean region had better infrastructure and funding for health care and more health care workers relative to the population. Various essential medicines were also more available and accessible. There was substantial variation in the prevalence of treated KF in the region, ranging from 137.4 per million population (pmp) in Jamaica to 2196 pmp in the United States. A mix of public and private funding systems cover costs for nondialysis chronic kidney disease care in 60% of countries and for dialysis in 70% of countries. Although the median number of nephrologists is 18.1 (interquartile range, 15.3–29.5) pmp, which is approximately twice the global median of 9.9 (interquartile range, 1.2–22.7) pmp, some countries reported shortages of other health care workers. Dialysis was available in all countries, but peritoneal dialysis was underutilized and unavailable in Barbados, Cayman Islands, and Turks and Caicos. Kidney transplantation was primarily available in Canada and the United States. Economic factors were the major barriers to optimal KF care in the Caribbean countries, and few countries in the region have chronic kidney disease–specific national health care policies. To address regional gaps in KF care delivery, efforts should be directed toward augmenting the workforce, improving the monitoring and reporting of kidney replacement therapy indicators, and implementing noncommunicable disease and chronic kidney disease–specific policies in all countries.

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国际肾脏病学会全球肾脏健康地图集:北美和加勒比地区肾衰竭管理的结构、组织和服务
国际肾脏病学会建立了全球肾脏健康地图集项目,以确定肾脏替代疗法和保守肾脏护理的全球能力,第二次迭代是描述全球肾衰竭(KF)护理的可用性,可及性,质量和可负担性。本报告介绍了北美和加勒比地区国际肾脏病学会的研究结果。与其他区域相比,北美和加勒比区域拥有更好的保健基础设施和资金,相对于人口而言,拥有更多的保健工作者。各种基本药物也更容易获得。在该地区,经治疗的KF患病率存在很大差异,从牙买加的每百万人口137.4例到美国的每百万人口2196例不等。在60%的国家和70%的国家,由公共和私人供资系统混合支付非透析慢性肾脏疾病护理费用。尽管肾病学家的中位数为18.1(四分位数范围为15.3-29.5),大约是全球中位数9.9(四分位数范围为1.2-22.7)的两倍,但一些国家报告了其他卫生保健工作者的短缺。所有国家都有透析,但在巴巴多斯、开曼群岛、特克斯和凯科斯群岛,腹膜透析利用不足,无法获得。肾移植主要在加拿大和美国进行。经济因素是加勒比国家实现最佳慢性肾脏病护理的主要障碍,该区域很少有国家有针对慢性肾病的国家保健政策。为了解决KF护理提供方面的区域差距,应努力增加劳动力,改进肾脏替代治疗指标的监测和报告,并在所有国家实施针对非传染性疾病和慢性肾脏疾病的政策。
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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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