International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in Eastern and Central Europe

  • Alicja Dębska-Ślizień
    Affiliations
    Department of Nephrology, Transplantation and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
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  • Author Footnotes
    20 AKB and DWJ are co-chairs for International Society of Nephrology Global Kidney Health Atlas Project.
    Aminu K. Bello
    Footnotes
    20 AKB and DWJ 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
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  • Author Footnotes
    20 AKB and DWJ are co-chairs for International Society of Nephrology Global Kidney Health Atlas Project.
    David W. Johnson
    Footnotes
    20 AKB and DWJ 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 (MINTS), 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
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  • Vivekanand Jha
    Affiliations
    George Institute for Global Health, University of New South Wales (UNSW), New Delhi, India

    School of Public Health, Imperial College, London, UK

    Manipal Academy of Higher Education, Manipal, India
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  • 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
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  • Adeera Levin
    Affiliations
    Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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  • 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
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  • Syed Saad
    Affiliations
    Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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  • Deenaz Zaidi
    Affiliations
    Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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  • Mohamed A. Osman
    Affiliations
    Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
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  • Feng Ye
    Affiliations
    Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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  • Maryam Khan
    Affiliations
    Faculty of Science, University of Alberta, Edmonton, Alberta, Canada
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  • Meaghan Lunney
    Affiliations
    Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
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  • 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
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  • Rumeyza Turan Kazancioglu
    Correspondence
    Correspondence: Rumeyza Turan Kazancioglu, Division of Nephrology, Bezmialem Vakif University, Adnan Menderes Bulvarı, Fatih, Istanbul 34390, Turkey.
    Affiliations
    Division of Nephrology, Bezmialem Vakif University, Istanbul, Turkey
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  • on behalf of theISN Eastern and Central Europe Regional Board
  • Author Footnotes
    20 AKB and DWJ are co-chairs for International Society of Nephrology Global Kidney Health Atlas Project.
      Provision of adequate kidney care for patients with chronic kidney disease or kidney failure (KF) is costly and requires extensive resources. There is an inequality in the global distribution of wealth and resources needed to provide this care. In this second iteration of the International Society of Nephrology Global Kidney Health Atlas, we present data for countries in Eastern and Central Europe. In the region, the median prevalence of chronic kidney disease was 13.15% and treated KF was 764 per million population, respectively, slightly higher than the global median of 759 per million population. In most countries in the region, over 90% of dialysis patients were on hemodialysis and patients with a functioning graft represented less than one-third of total patients with treated KF. The median annual costs for maintenance hemodialysis were close to the global median, and public funding provided nearly universal coverage of the costs of kidney replacement therapy. Nephrologists were primarily responsible for KF care. All countries had the capacity to provide long-term hemodialysis, and 95% had the capacity to provide peritoneal dialysis. Home hemodialysis was generally not available. Kidney transplantation and conservative care were available across most of the region. Almost all countries had official dialysis and transplantation registries. Eastern and Central Europe is a region with a high burden of chronic kidney disease and variable capacity to deal with it. Insufficient funding and workforce shortages coupled with increasing comorbidities among aging patients and underutilization of cost-effective dialysis therapies such as peritoneal dialysis and kidney transplantation may compromise the quality of care for patients with KF. Some workforce shortages could be addressed by improving the organization of nephrological care in some countries of the region.

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