International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in Oceania and South East Asia

  • Isabelle Ethier
    Affiliations
    Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia

    Division of Nephrology, Centre Hospitalier de l’Université de Montréal, Montréal, Quebec, Canada
    Search for articles by this author
  • Author Footnotes
    25 DWS and AKB are co-chairs for International Society of Nephrology Global Kidney Health Atlas Project.
    David W. Johnson
    Footnotes
    25 DWS and AKB are co-chairs for International Society of Nephrology Global Kidney Health Atlas Project.
    Affiliations
    Department of Nephrology, Metro South and Ipswich Nephrology and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia

    Centre for Kidney Disease Research, University of Queensland at Princess Alexandra Hospital, Brisbane, Queensland, Australia

    Translation Research Institute, Brisbane, Queensland, Australia
    Search for articles by this author
  • Author Footnotes
    25 DWS and AKB are co-chairs for International Society of Nephrology Global Kidney Health Atlas Project.
    Aminu K. Bello
    Footnotes
    25 DWS and AKB are co-chairs for International Society of Nephrology Global Kidney Health Atlas Project.
    Affiliations
    Division of Nephrology and Immunology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
    Search for articles by this author
  • Feng Ye
    Affiliations
    Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
    Search for articles by this author
  • Mohamed A. Osman
    Affiliations
    Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
    Search for articles by this author
  • Adeera Levin
    Affiliations
    Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
    Search for articles by this author
  • David C.H. Harris
    Affiliations
    Centre for Transplantation and Renal Research, The Westmead Institute for Medical Research, University of Sydney, Westmead, New South Wales, Australia
    Search for articles by this author
  • Peter Kerr
    Affiliations
    Nephrology, Monash Medical Centre, Victoria, Australia
    Search for articles by this author
  • Adrian Liew
    Affiliations
    The Kidney & Transplant Practice, Mount Elizabeth Novena Hospital, Singapore
    Search for articles by this author
  • Muh Geot Wong
    Affiliations
    Department of Renal Medicine, Royal North Shore Hospital, University of Sydney, New South Wales, Australia

    The George Institute for Global Health, Sydney, Australia
    Search for articles by this author
  • Meaghan Lunney
    Affiliations
    Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
    Search for articles by this author
  • Syed Saad
    Affiliations
    Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
    Search for articles by this author
  • Deenaz Zaidi
    Affiliations
    Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
    Search for articles by this author
  • Maryam Khan
    Affiliations
    Faculty of Science, University of Alberta, Edmonton, Alberta, Canada
    Search for articles by this author
  • Vivekanand Jha
    Affiliations
    George Institute for Global Health, University of New South Wales, New Delhi, India

    School of Public Health, Imperial College, London, UK

    Manipal Academy of Higher Education, Manipal, India
    Search for articles by this author
  • Marcello Tonelli
    Affiliations
    Department of Medicine, University of Calgary, Calgary, Alberta, Canada

    Pan-American Health Organization/World Health Organization’s Collaborating Centre in Prevention and Control of Chronic Kidney Disease, University of Calgary, Calgary, Alberta, Canada
    Search for articles by this author
  • Ikechi G. Okpechi
    Affiliations
    Department of Medicine, University of Alberta, Edmonton, Alberta, Canada

    Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa

    Kidney and Hypertension Research Unit, University of Cape Town, Cape Town, South Africa
    Search for articles by this author
  • Andrea K. Viecelli
    Correspondence
    Correspondence: Andrea K. Viecelli, Department of Nephrology, Level 2, Ambulatory Renal and Transplant Services Bldg, Princess Alexandra Hospital, 199 Ipswich Rd, Woolloongabba, Brisbane, Queensland, 4102, Australia.
    Affiliations
    Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia

    Centre for Kidney Disease Research, University of Queensland, Brisbane, Queensland, Australia
    Search for articles by this author
  • on behalf of theISN Oceania and South East Asia Regional Board
  • Author Footnotes
    25 DWS and AKB are co-chairs for International Society of Nephrology Global Kidney Health Atlas Project.
      Oceania and South East Asia (OSEA) is a socioeconomically, culturally, and ethnically diverse region facing a rising epidemic of noncommunicable diseases, including chronic kidney disease (CKD). The second iteration of the International Society of Nephrology Global Kidney Health Atlas aimed to provide a comprehensive evaluation of kidney care in OSEA. Of the 30 countries/territories in OSEA, 15 participated in the survey, representing 98.5% of the region’s population. The median prevalence of treated kidney failure in OSEA was 1352 per million population (interquartile range, 966–1673 per million population), higher than the global median of 787 per million population. Although the general availability, access, and quality of kidney replacement therapy (i.e., dialysis and transplantation) was high in OSEA, inequalities in accessibility and affordability of kidney replacement therapy across the region resulted in variability between countries. According to the survey results, in a third of the participating countries (mostly lower-income countries), less than half the patients with kidney failure were able to access dialysis, whereas it was readily available to all with minimal out-of-pocket costs in high-income countries; similar variability in access to transplantation was also recorded. Limitations in workforce and resources vary across the region and were disproportionately worse in lower-income countries. There was little advocacy for kidney disease, moderate use of registries, restricted CKD detection programs, and limited availability of routine CKD testing in some high-risk groups across the region. International collaborations, as seen in OSEA, are important initiatives to help close the gaps in CKD care provision across the region and should continue receiving support from the global nephrology community.

      Keywords

      To read this article in full you will need to make a payment
      ISN Member Login
      ISN Members, full access to the journal is a member benefit. Use your society credentials to access all journal content and features.
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • World Health Organization
        South-East Asia.
        (Available at:)
        https://www.who.int/southeastasia
        Date accessed: June 17, 2020
        • World Health Organization
        Western Pacific.
        (Available at:)
        https://www.who.int/westernpacific/
        Date accessed: June 17, 2020
        • Bello A.
        • Levin A.
        • Lunney M.
        • et al.
        Global Kidney Health Atlas: A Report by the International Society of Nephrology on the Global Burden of End-Stage Kidney Disease and Capacity for Kidney Replacement Therapy and Conservative Care Across World Countries and Regions.
        International Society of Nephrology, Brussels, Belgium2019
        • Cho Y.
        • Palmer S.
        • Johnson D.W.
        Chapter 81. Global considerations in kidney disease: Oceania region.
        in: Yu A. Chertow G. Luyckx V. Brenner & Rector’s the Kidney. 11th ed. Elsevier, Philadelphia, PA2019: 2588-2607
        • Kerr P.G.
        • Tran H.T.B.
        • Ha Phan H.A.
        • et al.
        Nephrology in the Oceania–South East Asia region: perspectives and challenges.
        Kidney Int. 2018; 94: 465-470
        • Bello A.K.
        • Okpechi I.G.
        • Jha V.
        • et al.
        Understanding distribution and variability in care organization and services for the management of kidney care across world regions.
        Kidney Int Suppl. 2021; 11:e4–e10
        • Central Intelligence Agency
        The world factbook.
        (Available at:)
        https://www.cia.gov/the-world-factbook/
        Date: Published 2019
        Date accessed: March 12, 2021
        • World Health Organization
        The Global Health Observatory.
        (Available at:)
        https://www.who.int/gho/en/
        Date accessed: June 22, 2020
        • van der Tol A.
        • Lameire N.
        • Morton R.
        • et al.
        An international analysis of dialysis services reimbursement.
        Clin J Am Soc Nephrol. 2019; 14: 84-93
        • Bello A.K.
        • Levin A.
        • Lunney M.
        • et al.
        Status of care for end stage kidney disease in countries and regions worldwide: international cross sectional survey.
        BMJ. 2019; 367: 15873
        • GODT
        Global Observatory on Donation and Transplantation summary.
        (Available at:)
        • Jain A.K.
        • Blake P.
        • Cordy P.
        • Garg A.X.
        Global trends in rates of peritoneal dialysis.
        J Am Soc Nephrol. 2012; 23: 533-544
        • Liyanage T.
        • Ninomiya T.
        • Jha V.
        • et al.
        Worldwide access to treatment for end-stage kidney disease: a systematic review.
        Lancet. 2015; 385: 1975-1982
      1. USRDS. United States Renal Data System. 2018 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2018.

        • World Bank
        GDP ranking, June 2019.
        (Available at:)
        • Agence de la Biomédecine
        Rapport annuel 2017: réseau epidémiologie et information en néphrologie.
        (Avaliable at:)
        • Ichiho H.M.
        • Roby F.T.
        • Ponausuia E.S.
        • et al.
        An assessment of non-communicable diseases, diabetes, and related risk factors in the territory of American Samoa: a systems perspective.
        Hawai’i J Med Public Heal. 2013; 72: 10-18
        • Krishnan A.
        • Chandra Y.
        • Malani J.
        • et al.
        End-stage kidney disease in Fiji.
        Intern Med J. 2019; 49: 461-466
        • Farah S.S.
        • Alhaji M.M.
        • Ahmed D.
        • et al.
        Barriers to kidney transplantation as a choice of renal replacement therapy.
        Transplant Proc. 2018; 50: 3165-3171
        • Tang S.C.W.
        • Yu X.
        • Chen H.C.
        • et al.
        Dialysis care and dialysis funding in Asia.
        Am J Kidney Dis. 2020; 75: 772-781
        • Surendra N.K.
        • Manaf M.R.A.
        • Hooi L.S.
        • et al.
        Cost utility analysis of end stage renal disease treatment in Ministry of Health dialysis centres, Malaysia: hemodialysis versus continuous ambulatory peritoneal dialysis.
        PLoS One. 2019; 14: 1-16
        • Afiatin
        • Khoe L.C.
        • Kristin E.
        • et al.
        Economic evaluation of policy options for dialysis in end-stage renal disease patients under the universal health coverage in Indonesia.
        PLoS One. 2017; 12: 1-10
        • Hyodo T.
        • Fukagawa M.
        • Hirawa N.
        • et al.
        Present status of renal replacement therapy in Asian countries as of 2016: Cambodia, Laos, Mongolia, Bhutan, and Indonesia.
        Ren Replace Ther. 2019; 5: 1-11
      2. Michel LM, Barroux N, Frimat L, et al. Telenephrology and on-site nephrology: comparable adequate dialysis care to patients living in remote Pacific Islands [epub ahead of print]. J Telemed Telecare. https://doi.org/10.1177/1357633X19896680. Accessed September 18, 2020.

        • Naganuma T.
        • Takemoto Y.
        Prospects for vascular access education in developing countries: current situation in Cambodia.
        Blood Purif. 2017; 44: 52-54
        • Naramura T.
        • Hyodo T.
        • Kokubo K.
        • et al.
        Dialysis and quality of dialysate in Southeast Asian developing countries.
        Nephron Extra. 2014; 4: 64-69
        • International Society of Nephrology
        Programs.
        (Available at:)