Access to essential medications and health products is critical to effective management
of kidney disease. Using data from the ISN Global Kidney Health Atlas multinational
cross-sectional survey, global access of patients with kidney disease to essential
medications and health products was examined. Overall, 125 countries participated,
with 118 countries, composing 91.5% of the world’s population, providing data on this
domain. Most countries were unable to access eGFR and albuminuria in their primary
care settings. Only one-third of low-income countries (LICs) were able to measure
serum creatinine and none were able to access eGFR or quantify proteinuria. The ability
to monitor diabetes mellitus through serum glucose and glycated hemoglobin measurements
was suboptimal. Pathology services were rarely available in tertiary care in LICs
(12%) and lower middle-income countries (45%). While acute and chronic hemodialysis
services were available in almost all countries, acute and chronic peritoneal dialysis
services were rarely available in LICs (18% and 29%, respectively). Kidney transplantation
was available in 79% of countries overall and in 12% of LICs. While over one-half
of all countries publicly funded RRT and kidney medications with or without copayment,
this was less common in LICs and lower middle-income countries. In conclusion, this
study demonstrated significant gaps in services for kidney care and funding that were
most apparent in LICs and lower middle-income countries.
Keywords
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Crown Copyright © 2017 Published by Elsevier, Inc., on behalf of the International Society of Nephrology. All rights reserved.
