The Future of Kidney Care in Low- and Middle-Income Countries: Challenges, Triumphs, and Opportunities

被引:2
作者
Kalyesubula, Robert [1 ,2 ,3 ]
Aklilu, Abinet M. [3 ]
Calice-Silva, Viviane [4 ,5 ]
Kumar, Vivek [6 ]
Kansiime, Grace [7 ]
机构
[1] Makerere Univ, Coll Hlth Sci, Dept Physiol, Kampala, Uganda
[2] Makerere Univ, Coll Hlth Sci, Dept Med, Kampala, Uganda
[3] Yale Sch Med, Sect Nephrol, New Haven, CT 06510 USA
[4] Prorim Fdn, Res Dept, Joinville, Brazil
[5] Univ Regiao Joinville, Sch Med, Joinville, Brazil
[6] Post Grad Inst Med Educ & Res, Dept Nephrol, Chandigarh, India
[7] Mbarara Univ Sci & Technol, Dept Med, Mbarara, Uganda
来源
KIDNEY360 | 2024年 / 5卷 / 07期
关键词
CKD; chronic kidney failure; hemodialysis; kidney dysfunction; mortality; HEALTH ATLAS STRUCTURES; SUB-SAHARAN AFRICA; INTERNATIONAL SOCIETY; NONCOMMUNICABLE DISEASES; PERITONEAL-DIALYSIS; MANAGEMENT; FAILURE; INJURY; EPIDEMIOLOGY; ORGANIZATION;
D O I
10.34067/KID.0000000000000489
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
CKD affects about 850 million people worldwide and is projected to be the fifth leading cause of death by 2040. Individuals from low- and middle-income countries (LMICs) bear the bulk of CKD. They face challenges including lack of awareness among the general population, as well as health care providers, unique risk factors such as genetic predispositions, infectious diseases, and environmental toxins, limited availability and affordability of diagnostic tests and medications, and limited access to KRTs. The inadequate health system infrastructure, human resources, and financing mechanisms to support comprehensive and integrated kidney care worsen the situation. Overcoming these challenges needs concerted efforts toward early detection, intervention, and multidisciplinary follow-up, policy, collaboration, advocacy, and financing. To achieve this, there is need for individual governments to include kidney health among the key health priorities and build capacity toward resilient health care systems. Integrating kidney care using the roadmaps of well-established management systems for other chronic diseases, such as HIV, has the potential to expedite the widespread adoption of kidney health. The aim of this article is to provide an overview of the current state and future prospects of kidney care in LMICs, highlighting the main challenges, ongoing efforts, and opportunities for improvement. We present case studies of exemplary efforts from three continents of the world with the highest densities of LMICs and propose potential strategies for a sustainable solution.
引用
收藏
页码:1047 / 1061
页数:15
相关论文
共 80 条
  • [1] PERITONEAL DIALYSIS TO TREAT PATIENTS WITH ACUTE KIDNEY INJURY-THE SAVING YOUNG LIVES EXPERIENCE IN WEST AFRICA: PROCEEDINGS OF THE SAVING YOUNG LIVES SESSION AT THE FIRST INTERNATIONAL CONFERENCE OF DIALYSIS IN WEST AFRICA, DAKAR, SENEGAL, DECEMBER 2015
    Abdou, Niang
    Antwi, Sampson
    Koffi, Laurence Adonis
    Lalya, Francis
    Adabayeri, Victoria May
    Nyah, Norah
    Palmer, Dennis
    Brusselmans, Ariane
    Cullis, Brett
    Feehally, John
    McCulloch, Mignon
    Smoyer, William
    Finkelstein, Fredric O.
    [J]. PERITONEAL DIALYSIS INTERNATIONAL, 2017, 37 (02): : 155 - 158
  • [2] Abeysekera R., 2023, Kidney Int Rep, V8, pS171, DOI [10.1016/j.ekir.2023.02.384, DOI 10.1016/J.EKIR.2023.02.384]
  • [3] The impact of kidney foundations in alleviating the burden of CKD in India - an example, Tamilnad Kidney Research Foundation
    Abraham, Georgi
    Vijayan, Madhusudan
    Ravi, Rajalakshmi
    Kumaraswami, Latha
    Venkatesan, Malathy
    [J]. CLINICAL NEPHROLOGY, 2016, 86 : S74 - S77
  • [4] Albuquerque ACRMD, 2023, J BRAS NEFROL, V45, P144, DOI [10.1590/2175-8239-JBN-2022-0017en, 10.1590/2175-8239-jbn-2022-0017en]
  • [5] [Anonymous], 2021, LINHA DE CUIDADO DA PESSOA COM DOENA RENAL CRNICA EM SANTA CATARINA
  • [6] Systematic review of diagnostic and prognostic models of chronic kidney disease in low-income and middle-income countries
    Aparcana-Granda, Diego J.
    Ascencio, Edson J.
    Larco, Rodrigo M. Carrillo
    [J]. BMJ OPEN, 2022, 12 (03):
  • [7] Spectrum of kidney diseases in Africa: malaria, schistosomiasis, sickle cell disease, and toxins
    Arogundade, Fatiu A.
    Hassan, Muzamil O.
    Omotoso, Bolanle A.
    Oguntola, Stephen O.
    Okunola, Oluyomi O.
    Sanusi, Abubakr A.
    Akinsola, Adewale
    [J]. CLINICAL NEPHROLOGY, 2016, 86 : S53 - S60
  • [8] Challenges to the right to health in sub-Saharan Africa: reflections on inequities in access to dialysis for patients with end-stage kidney failure
    Ashu, James Tataw
    Mwangi, Jackline
    Subramani, Supriya
    Kaseje, Daniel
    Ashuntantang, Gloria
    Luyckx, Valerie A.
    [J]. INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH, 2022, 21 (01)
  • [9] Bello AK, 2023, ISNGlobal Kidney Health Atlas: A report by the International Society of Nephrology: An Assessment of Global Kidney Health Care Status focussing on Capacity, Availability, Accessibility, Affordability and Outcomes of Kidney Disease
  • [10] Bello AK, 2024, LANCET GLOB HEALTH, V12, pe382, DOI 10.1016/S2214-109X(23)00570-3