PracticeUpdate Conference Series ISN WCN 2019

Global Kidney Health Atlas Reveals Worldwide Gaps in Care Education is a key component of improved prevention and treatment of kidney disease.

T he growing burden of kidney disease world- wide combined with the increasing expense of care for kidney failure and evidence regard- ing the value of delaying progression of chronic kidney disease means that access to prevention and treatment should be a major international pub- lic health goal, according to the second Global Kidney Health Atlas, unveiled for the first time at WCN 2019. The first Global Kidney Health Atlas was presented at the International Society of Nephrology (ISN) Global Kidney Policy Forum in Mexico City in 2017 and focused on awareness of chronic kidney dis- ease and detection programs. The latest edition examines the state of kidney health care structures across 160 countries, comprising more than 98% of the world’s population, including a comprehen- sive overview of the current capacity for end-stage kidney disease (ESKD). One of the highlights of the 2019 Atlas is the identification of the top barriers to optimal care ƒ ƒ Patient knowledge or attitude (63% of countries) ƒ ƒ Availability of kidney specialists (60% of countries) ƒ ƒ Other physician availability, access, knowledge and/or attitude (58% of countries) ƒ ƒ Distance from care or prolonged travel time (55% of countries) ƒ ƒ Availability, access and capacity of the healthcare system (55% of countries). for patients with ESKD. This includes: ƒ ƒ Economic factors (64% of countries)

Dr. Peter Kerr

A co-author of the Atlas, Peter Kerr, MD, of Monash University in Clayton, Victoria, told Elsevier’s PracticeUpdate that, “Two-thirds of the world’s population with ESKD is not getting access to renal replacement therapy, whether that be dialysis or transplant. That’s an enormous hole in provision of care.” He noted that the cost of renal replacement ther- apy is high, so discussion needs to focus on early detection and prevention of progression, as well as provision of care when needed. “Most countries in the survey have access to hemodialysis in some form or another, but the number who have access to transplantation is far less,” Dr. Kerr said. “And transplantation has a much better outcome for patients, not only in terms of wellness but also quality of life. There is also an economic component because it’s cheaper to do transplantation, particularly after the first year of dialysis, and also people returning to the workforce is more likely.”

" …transplantation has a much better

outcome for patients, not only in terms of wellness but also quality of life. "

PRACTICEUPDATE CONFERENCE SERIES • WCN 2019 14