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Increasing access to integrated ESKD care as part of Universal Health Coverage

Murtagh, Fliss E.M.; Yao, Qiang; Walker, Robert; Walker, Rachael C.; Vachharajani, Tushar; Tungsanga, Kriang; Trask, Michele; Tesar, Vladimir; Tchokhonelidze, Irma; Schneditz, Daniel; Saleh, Abdulkarim; Sahay, Manisha; Rondeau, Eric; Richards, Marie; Rashid, Harun Ur; Rahman, Muhibur; Perl, Jeffrey; Ossareh, Shahrzad; Obrador, Gregorio T.; Niang, Abdou; Nangaku, Masaomi; Naicker, Saraladevi; Muller, Elmi; Morton, Rachael L.; Mengistu, Yewondwassesn Tadesse; McKnight, Marla; Liew, Adrian; Levin, Adeera; Kazancioglu, Rumeyza T.; Kalantar-Zadeh, Kamyar; Hou, Fan Fan; Hassan, Mohamed H.; Goh, Bak Leong; Ghnaimat, Mohammad A.; Feehally, John; Eke, Felicia U.; Eiam-Ong, Somchai; Dreyer, Gavin; Douthat, Walter; Were, Anthony J.O.; Jager, Kitty; Harris, David C.H.; Davies, Simon J.; Finkelstein, Fredric O.; Jha, Vivekanand; Donner, Jo Ann; Abraham, Georgi; Bello, Aminu K.; Caskey, Fergus J.; Garcia, Guillermo Garcia; Harden, Paul; Hemmelgarn, Brenda; Johnson, David W.; Levin, Nathan W.; Luyckx, Valerie A.; Martin, Dominique E.; McCulloch, Mignon I.; Moosa, Mohammed Rafique; O'Connell, Philip J.; Okpechi, Ikechi G.; Pecoits Filho, Roberto; Shah, Kamal D.; Sola, Laura; Swanepoel, Charles; Tonelli, Marcello; Twahir, Ahmed; van Biesen, Wim; Varghese, Cherian; Yang, Chih Wei; Zuniga, Carlos; Abu Alfa, Ali K.; Aljubori, Harith M.; Alrukhaimi, Mona N.; Andreoli, Sharon P.; Ashuntantang, Gloria; Bellorin-Font, Ezequiel; Cueto-Manzano, Alfonso; Bernieh, Bassam; Ibhais, Fuad M.; Blake, Peter G.; Brown, Mark; Brown, Edwina; Bunnag, Sakarn; Chan, Tak Mao; Chen, Yuqing; Claure-Del Granado, Rolando; Claus, Stefaan; Collins, Allan; Couchoud, Cecile; Cullis, Brett; Murtagh, Fliss


Fliss E.M. Murtagh

Qiang Yao

Robert Walker

Rachael C. Walker

Tushar Vachharajani

Kriang Tungsanga

Michele Trask

Vladimir Tesar

Irma Tchokhonelidze

Daniel Schneditz

Abdulkarim Saleh

Manisha Sahay

Eric Rondeau

Marie Richards

Harun Ur Rashid

Muhibur Rahman

Jeffrey Perl

Shahrzad Ossareh

Gregorio T. Obrador

Abdou Niang

Masaomi Nangaku

Saraladevi Naicker

Elmi Muller

Rachael L. Morton

Yewondwassesn Tadesse Mengistu

Marla McKnight

Adrian Liew

Adeera Levin

Rumeyza T. Kazancioglu

Kamyar Kalantar-Zadeh

Fan Fan Hou

Mohamed H. Hassan

Bak Leong Goh

Mohammad A. Ghnaimat

John Feehally

Felicia U. Eke

Somchai Eiam-Ong

Gavin Dreyer

Walter Douthat

Anthony J.O. Were

Kitty Jager

David C.H. Harris

Simon J. Davies

Fredric O. Finkelstein

Vivekanand Jha

Jo Ann Donner

Georgi Abraham

Aminu K. Bello

Fergus J. Caskey

Guillermo Garcia Garcia

Paul Harden

Brenda Hemmelgarn

David W. Johnson

Nathan W. Levin

Valerie A. Luyckx

Dominique E. Martin

Mignon I. McCulloch

Mohammed Rafique Moosa

Philip J. O'Connell

Ikechi G. Okpechi

Roberto Pecoits Filho

Kamal D. Shah

Laura Sola

Charles Swanepoel

Marcello Tonelli

Ahmed Twahir

Wim van Biesen

Cherian Varghese

Chih Wei Yang

Carlos Zuniga

Ali K. Abu Alfa

Harith M. Aljubori

Mona N. Alrukhaimi

Sharon P. Andreoli

Gloria Ashuntantang

Ezequiel Bellorin-Font

Alfonso Cueto-Manzano

Bassam Bernieh

Fuad M. Ibhais

Peter G. Blake

Mark Brown

Edwina Brown

Sakarn Bunnag

Tak Mao Chan

Yuqing Chen

Rolando Claure-Del Granado

Stefaan Claus

Allan Collins

Cecile Couchoud

Brett Cullis


The global nephrology community recognizes the need for a cohesive strategy to address the growing problem of end-stage kidney disease (ESKD). In March 2018, the International Society of Nephrology hosted a summit on integrated ESKD care, including 92 individuals from around the globe with diverse expertise and professional backgrounds. The attendees were from 41 countries, including 16 participants from 11 low- and lower-middle–income countries. The purpose was to develop a strategic plan to improve worldwide access to integrated ESKD care, by identifying and prioritizing key activities across 8 themes: (i) estimates of ESKD burden and treatment coverage, (ii) advocacy, (iii) education and training/workforce, (iv) financing/funding models, (v) ethics, (vi) dialysis, (vii) transplantation, and (viii) conservative care. Action plans with prioritized lists of goals, activities, and key deliverables, and an overarching performance framework were developed for each theme. Examples of these key deliverables include improved data availability, integration of core registry measures and analysis to inform development of health care policy; a framework for advocacy; improved and continued stakeholder engagement; improved workforce training; equitable, efficient, and cost-effective funding models; greater understanding and greater application of ethical principles in practice and policy; definition and application of standards for safe and sustainable dialysis treatment and a set of measurable quality parameters; and integration of dialysis, transplantation, and comprehensive conservative care as ESKD treatment options within the context of overall health priorities. Intended users of the action plans include clinicians, patients and their families, scientists, industry partners, government decision makers, and advocacy organizations. Implementation of this integrated and comprehensive plan is intended to improve quality and access to care and thereby reduce serious health-related suffering of adults and children affected by ESKD worldwide.

Journal Article Type Review
Publication Date Apr 1, 2019
Journal Kidney International
Print ISSN 0085-2538
Electronic ISSN 1523-1755
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 95
Issue 4
Pages S1-S33
APA6 Citation Yao, Q., Walker, R., Walker, R. C., Vachharajani, T., Tungsanga, K., Trask, M., …Murtagh, F. (2019). Increasing access to integrated ESKD care as part of Universal Health Coverage. Kidney International, 95(4), S1-S33.
Keywords ESKD (end-stage kidney disease); UHC (universal health coverage); Dialysis; Transplantation; Conservative care; Advocacy; Training; Funding
Publisher URL


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Copyright Statement
© 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license

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