PracticeUpdate Conference Series ISN WCN 2019

have to extend our expertise to those in primary care and to general internists. Indonesia is a good example of that. They created public access dialysis unified healthcare and went from 1200 dialysis patients to 57,000, and yet they only have 130 nephrologists.” Another component of education involves efforts to get major bodies like the World Health Organization (WHO) to “wake up” to issues relating to nephrology, said Dr. Kerr. “The WHO has a big non-com- municable disease strategy, and they are focused on the heart and diabetes and obesity, but they have forgotten that nephrology is an integral component of that. It is a bigger risk factor for heart disease than things like cholesterol. We are pushing to get kidney disease on the agenda.”

expertise and infrastructure in some regions. The ISN has spearheaded effec- tive programs in which physicians from regions without the needed expertise, such as Kathmandu, visit regions that do, such as Dr. Kerr’s institution in Australia, for education. Another ISN program aligns units in the developing world with units in a developed country, fostering a long-term partnership involving educa- tional exchanges and visits. “That’s a very strong program that’s been very fruitful,” said Dr. Kerr. Another important strategy is to educate primary care physicians on simple and straightforward preventive approaches, such as monitoring and management of blood pressure. In some regions, primary care providers can play a more active role. “We are trying to develop an informed workforce in the developing countries,” said Dr. Kerr. “We

The ISN is improving capacity in the developing world to manage ESKD by leveraging expertise in the developed world. By contacting their local ISN regional board, said Dr. Kerr, physicians can learn about what programs are avail- able in their region, which they can either contribute to or benefit from. Information on these programs is also available at www.theisn.org . Nevertheless, uptake in some regions remains low, likely because those who need the resources are simply unaware they exist. “Institutions like the ISN haven’t got the capacity to provide facilities or capital or salaries, but they have the capacity to provide education and instill that capacity- building approach,” said Dr. Kerr. “There is a lot expertise available, and a lot of people willing to provide that expertise.” The primary barrier to increased trans- plantation remains lack of appropriate

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WCN 2019 • PRACTICEUPDATE CONFERENCE SERIES 15