Disparities in kidney care in vulnerable populations: A multinational study from the ISN-GKHA

Vulnerable populations, such as the elderly, children, displaced people, and refugees, often encounter challenges in accessing healthcare. In this study, we used data from the third iteration of the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA) to describe kidney care access and delivery to vulnerable populations across countries and regions. Using data from an international survey of clinicians, policymakers, and patient advocates, we assessed the funding and coverage of vulnerable populations on all aspects of kidney replacement therapies (KRT). Overall, 167 countries or jurisdictions participated in the survey, representing 97.4% of the world's population. Children had less access than adults to KRT: hemodialysis (HD) in 74% of countries, peritoneal dialysis (PD) in 53% of countries, and kidney transplantation (KT) in 80% of countries. Available nephrologist workforce for pediatric kidney care was much lower than for adults (0.69 per million population [pmp] vs 10.08 pmp). Refugees or displaced people with kidney failure did not have access to HD, PD, or KT in 21%, 33%, and 37% of the participating countries, respectively. Low-income countries (LICs) were less likely to provide KRT access to refugees compared to high-income countries (HICs): HD: 13% vs 22%; PD: 19% vs 61%; KT: 30% vs 44%. Testing for kidney disease was routinely offered to elderly people in only 61% of countries: LICs (45%), lower-middle-income countries (56%), upper-middle-income countries (54%), and HICs (75%). Equitable access to kidney care for vulnerable people, particularly for children and displaced people, remains an area of unmet need. Strategies are needed to address this issue.

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Publication Details

Journal
PLOS Global Public Health
Published
2024-12-20
DOI
https://doi.org/10.1371/journal.pgph.0004086
Citations
6
Primary Topic
Dialysis and Renal Disease Management
Type
article
Field-Weighted Citation Impact
2.04

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article

Disparities in kidney care in vulnerable populations: A multinational study from the ISN-GKHA

Sandrine Damster, Aminu K. Bello, Syed Saad, Christopher Imokhuede Esezobor et al.
6 citations
PLOS Global Public Health
Dialysis and Renal Disease Management
2.04
article

Disparities in kidney care in vulnerable populations: A multinational study from the ISN-GKHA

Sandrine Damster, Aminu K. Bello, Syed Saad, Christopher Imokhuede Esezobor, Marcello Tonelli, Masaomi Nangaku, Vivekanand Jha, Ikechi G. Okpechi, David Wayne Johnson, Nivedita Kamath, Jo‐Ann Donner, Arpana Iyengar, Robin L. Erickson, Adebowale Ademola, Fergus John Caskey, Erin Hedin, Silvia Arruebo, Feng Ye, Rowena Lalji, Adeera Levin
article en
6 citations

Abstract

Vulnerable populations, such as the elderly, children, displaced people, and refugees, often encounter challenges in accessing healthcare. In this study, we used data from the third iteration of the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA) to describe kidney care access and delivery to vulnerable populations across countries and regions. Using data from an international survey of clinicians, policymakers, and patient advocates, we assessed the funding and coverage of vulnerable populations on all aspects of kidney replacement therapies (KRT). Overall, 167 countries or jurisdictions participated in the survey, representing 97.4% of the world's population. Children had less access than adults to KRT: hemodialysis (HD) in 74% of countries, peritoneal dialysis (PD) in 53% of countries, and kidney transplantation (KT) in 80% of countries. Available nephrologist workforce for pediatric kidney care was much lower than for adults (0.69 per million population [pmp] vs 10.08 pmp). Refugees or displaced people with kidney failure did not have access to HD, PD, or KT in 21%, 33%, and 37% of the participating countries, respectively. Low-income countries (LICs) were less likely to provide KRT access to refugees compared to high-income countries (HICs): HD: 13% vs 22%; PD: 19% vs 61%; KT: 30% vs 44%. Testing for kidney disease was routinely offered to elderly people in only 61% of countries: LICs (45%), lower-middle-income countries (56%), upper-middle-income countries (54%), and HICs (75%). Equitable access to kidney care for vulnerable people, particularly for children and displaced people, remains an area of unmet need. Strategies are needed to address this issue.

PLOS Global Public HealthVol. 4(12)
Translational Research Institute (AU), University of British Columbia (CA), University of Auckland (NZ), University of Alberta (CA), University of Cape Town (ZA), Manipal Academy of Higher Education (IN), The University of Queensland (AU), University of Calgary (CA), University of Ibadan (NG), University of Lagos (NG), University College Hospital, Ibadan (NG), Princess Alexandra Hospital (AU), University of Bristol (GB), Kidney Health Australia (AU), St. John's National Academy of Health Sciences (IN), George Institute for Global Health (IN), Starship Children's Health (NZ), St.John's Medical College Hospital (IN), Children's Health Queensland Hospital and Health Service (AU), Imperial College London (GB), The University of Tokyo (JP)
Amgen, Eli Lilly and Company, AstraZeneca, Heart and Stroke Foundation of Canada, International Society of Nephrology, Fresenius Medical Care North America, University of Alberta, Astellas Pharma, Akebia Therapeutics, Chugai Pharmaceutical, Medical Research Council, National Health and Medical Research Council, Daiichi Sankyo Europe
No poverty
Openalex Percentile: Top 11%
Dialysis and Renal Disease Management
2.04
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