Equity and Quality of Global Chronic Kidney Disease Care: What Are We Waiting for?

Publication Title

American journal of nephrology

Document Type

Article

Publication Date

1-1-2024

Keywords

washington; spokane; pmrc; diversity; Humans; Renal Insufficiency, Chronic; Global Health; Quality of Health Care; Healthcare Disparities; Health Services Accessibility; Health Equity

Abstract

BACKGROUND: Chronic kidney disease (CKD) is an important but insufficiently recognized public health problem. Unprecedented advances in delaying progression of CKD and reducing kidney failure and death have been made in recent years, with the addition of the sodium-glucose cotransporter 2 inhibitors and other newer medication to the established standard of care with inhibitors of the renin-angiotensin system. Despite knowledge of these effective therapies, their prescription and use remain suboptimal globally, and more specially in low resource settings. Many challenges contribute to this gap between knowledge and translation into clinical care, which is even wider in lower resource settings across the globe. Implementation of guideline-directed care is hampered by lack of disease awareness, late or missed diagnosis, clinical inertia, poor quality care, cost of therapy, systemic biases, and lack of patient empowerment. All of these are exacerbated by the social determinants of health and global inequities.

SUMMARY: CKD is a highly manageable condition but requires equitable and sustainable access to quality care supported by health policies, health financing, patient and health care worker education, and affordability of medications and diagnostics.

KEY MESSAGES: The gap between the knowledge and tools to treat CKD and the implementation of optimal quality kidney care should no longer be tolerated. Advocacy, research and action are required to improve equitable access to sustainable quality care for CKD everywhere.

Clinical Institute

Kidney & Diabetes

Specialty

Endocrinology

Specialty

Nephrology

Specialty

Population Health

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