Considerations on equity in management of end-stage kidney disease in low- and middle-income countries

Van Biesen, Wim; Jha, Vivekanand; Abu-Alfa, Ali K.; Andreoli, Sharon P.; Ashuntantang, Gloria; Bernieh, Bassam; Brown, Edwina; Chen, Yuqing; Coppo, Rosanna; Couchoud, Cecile; Cullis, Brett; Douthat, Walter; Eke, Felicia U.; Hemmelgarn, Brenda; Hou, Fan Fan; Levin, Nathan W.; Luyckx, Valerie A.; Morton, Rachael L.; Moosa, Mohammed Rafique; Murtagh, Fliss E.M.; Richards, Marie; Rondeau, Eric; Schneditz, Daniel; Shah, Kamal D.; Tesar, Vladimir; Yeates, Karen; Garcia Garcia, Guillermo

Abstract

Achievement of equity in health requires development of a health system in which everyone has a fair opportunity to attain their full health potential. The current, large country-level variation in the reported incidence and prevalence of treated end-stage kidney disease indicates the existence of system-level inequities. Equitable implementation of kidney replacement therapy (KRT) programs must address issues of availability, affordability, and acceptability. The major structural factors that impact equity in KRT in different countries are the organization of health systems, overall health care spending, funding and delivery models, and nature of KRT prioritization (transplantation, hemodialysis or peritoneal dialysis, and conservative care). Implementation of KRT programs has the potential to exacerbate inequity unless equity is deliberately addressed. In this review, we summarize discussions on equitable provision of KRT in low- and middle-income countries and suggest areas for future research.

Citation

Van Biesen, W., Jha, V., Abu-Alfa, A. K., Andreoli, S. P., Ashuntantang, G., Bernieh, B., …Garcia Garcia, G. (2020). Considerations on equity in management of end-stage kidney disease in low- and middle-income countries. Kidney International Supplements, 10(1), e63-e71. https://doi.org/10.1016/j.kisu.2019.11.004

• Journal Article Type: Article
• Acceptance Date: Nov 7, 2019
• Online Publication Date: Feb 19, 2020
• Publication Date: 2020-03
• Deposit Date: Feb 23, 2020
• Publicly Available Date: Feb 20, 2021
• Journal: Kidney International Supplements
• Print ISSN: 2157-1716
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 10
• Issue: 1
• Pages: e63-e71
• DOI: https://doi.org/10.1016/j.kisu.2019.11.004
• Keywords: Nephrology; end-stage kidney disease; equity; ethical framework; kidney replacement therapy; reimbursement; social justice
• Public URL: https://hull-repository.worktribe.com/output/3444546