NEW YORK (Reuters Health) – By 2030, 14.5 million people around the world will have end-stage kidney disease (ESKD), yet only 5.4 million will be treated due to economic, social and political factors. And more than 2 million people will die each year due to little or no access to hemodialysis or kidney transplantation.
ESKD is a “major public health problem due to associated adverse health consequences and costs of treatment,” ISN President Dr. David Harris said in a foreword to the 172-page report. “People with ESKD require frequent and intensive care that is burdensome to their lifestyles and expensive. In many countries where ESKD care is not publicly funded, people with ESKD are unable to receive treatment, resulting in poor health outcomes and often death.”
The report paints a picture of the state of kidney health care structures across 160 countries that include more than 98% of the world’s population.
According to the report, roughly 10% of the world’s population is living with chronic kidney disease (CKD) and about 0.1% has ESKD. Most of these individuals are from low-income countries. Only 4% of populations living with ESKD in low-income countries have access to dialysis or transplantation, compared to 60% in high-income countries.
Chief barriers to optimal ESKD care around the world are economic factors (reported by 64% of countries); patient knowledge or attitude (in 63% of countries); availability of kidney specialists (60% of countries); other physician availability, access, knowledge, and/or attitude (58%); distance from care or prolonged travel time (55%); and availability, access, and capacity of the healthcare system (55% of countries).
“The next steps to enhance kidney care delivery are multifactorial,” the report states. “Preventing ESKD through appropriate acute kidney injury (AKI) and CKD detection programs is essential. Furthermore, supporting non-dialysis CKD through enhanced public funding will slow the progression of kidney disease, thereby reducing the use of expensive and resource-intensive kidney replacement therapies and the burden of ESKD on patients and their families.”
International Society of Nephrology (ISN) 2019.