scholarly journals STEP BY STEP GUIDE TO SET UP A KIDNEY REPLACEMENT THERAPY REGISTRY The challenge of a National Kidney Replacement Therapy Registry

2021 ◽  
Author(s):  
Guillermo Rosa-Diez ◽  
María Carlota González-Bedat ◽  
Rosario Luxardo ◽  
María Laura Ceretta ◽  
Alejandro Ferreiro-Fuentes
Keyword(s):  
Kidney Disease ◽  
Replacement Therapy ◽  
Latin American ◽  
Population Based ◽  
Kidney Replacement Therapy ◽  
Pan American ◽  
Set Up ◽  
Health Organization ◽  
End Stage ◽  
Minimum Quality

Abstract Chronic Kidney Disease (CKD) has become one of the most important public health problems worldwide. The analysis and understanding of this global/national/regional reality would benefit from the data of the renal registries. The implementation of a CKD registry (including all categories) is difficult to achieve given its high cost. On the other hand, patients with end-stage kidney disease (ESKD) are easily accessible and constitute the subgroup of greater severity. A Kidney Replacement Therapy Registry (KRTR) is defined as a systematic and continuous collection of a population-based dataset of ESKD patients treated by dialysis/kidney transplant. The lack of available data, particularly in emerging economies, leaves information gaps on health care and outcomes in these patients. The heterogeneity/absence of KRTR in some countries is consistent with the inequities in the access to kidney replacement therapy (KRT) all over the world. In 2014, The Pan American Health Organization (PAHO) proposed to achieve at least a prevalence of KRT patients of 700 pmp by 2019 in every Latin American (LA) country. Since then, PAHO and SLANH (Sociedad Latino Americana de Nefrología e Hipertensión) lead courses of training and certification of KRTR in Latin America. The purpose of this manuscript is to provide guidance on how to set-up a new KRTR in countries or regions still lacking one. Advice is provided on the sequence of steps to setup a KRTR, personnel requirements, dataset content and minimum quality indicators required.

scholarly journals Pregnancy and delivery in women treated with renal replacement therapy: A literature review

2021 ◽  
pp. 86-90
Author(s):  
V. Medved ◽  
L. Bulik
Keyword(s):  
Kidney Disease ◽  
Replacement Therapy ◽  
Perinatal Outcomes ◽  
Published Data ◽  
Perinatal Complications ◽  
End Stage Kidney Disease ◽  
Dialysis Therapy ◽  
Pregnancy And Delivery ◽  
Kidney Replacement Therapy ◽  
End Stage

Abstract. The problem of pregnancy and delivery in women with end-stage kidney disease is becoming increasingly important, and the number of such women who are pregnant, receiving kidney replacement therapy, is growing every year. Improvements in dialysis therapy have led to improved obstetric and perinatal outcomes, but the risk of various obstetric and perinatal complications remains extremely high. In this review, we analyzed recently published data on management and outcomes of pregnancy in women with end-stage kidney disease receiving dialysis.

scholarly journals Status of care for end stage kidney disease in countries and regions worldwide: international cross sectional survey

BMJ ◽  
2019 ◽  
pp. l5873 ◽  
Author(s):  
Aminu K Bello ◽  
Adeera Levin ◽  
Meaghan Lunney ◽  
Mohamed A Osman ◽  
Feng Ye ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Low Income ◽  
Care Delivery ◽  
End Stage Kidney Disease ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Kidney Replacement Therapy ◽  
End Stage

Abstract Objective To determine the global capacity (availability, accessibility, quality, and affordability) to deliver kidney replacement therapy (dialysis and transplantation) and conservative kidney management. Design International cross sectional survey. Setting International Society of Nephrology (ISN) survey of 182 countries from July to September 2018. Participants Key stakeholders identified by ISN’s national and regional leaders. Main outcome measures Markers of national capacity to deliver core components of kidney replacement therapy and conservative kidney management. Results Responses were received from 160 (87.9%) of 182 countries, comprising 97.8% (7338.5 million of 7501.3 million) of the world’s population. A wide variation was found in capacity and structures for kidney replacement therapy and conservative kidney management—namely, funding mechanisms, health workforce, service delivery, and available technologies. Information on the prevalence of treated end stage kidney disease was available in 91 (42%) of 218 countries worldwide. Estimates varied more than 800-fold from 4 to 3392 per million population. Rwanda was the only low income country to report data on the prevalence of treated disease; 5 (<10%) of 53 African countries reported these data. Of 159 countries, 102 (64%) provided public funding for kidney replacement therapy. Sixty eight (43%) of 159 countries charged no fees at the point of care delivery and 34 (21%) made some charge. Haemodialysis was reported as available in 156 (100%) of 156 countries, peritoneal dialysis in 119 (76%) of 156 countries, and kidney transplantation in 114 (74%) of 155 countries. Dialysis and kidney transplantation were available to more than 50% of patients in only 108 (70%) and 45 (29%) of 154 countries that offered these services, respectively. Conservative kidney management was available in 124 (81%) of 154 countries. Worldwide, the median number of nephrologists was 9.96 per million population, which varied with income level. Conclusions These comprehensive data show the capacity of countries (including low income countries) to provide optimal care for patients with end stage kidney disease. They demonstrate substantial variability in the burden of such disease and capacity for kidney replacement therapy and conservative kidney management, which have implications for policy.

scholarly journals Capturing and monitoring global differences in untreated and treated end-stage kidney disease, kidney replacement therapy modality, and outcomes

2020 ◽  
Vol 10 (1) ◽  
pp. e3-e9 ◽  
Author(s):  
Roberto Pecoits-Filho ◽  
Ikechi G. Okpechi ◽  
Jo-Ann Donner ◽  
David C.H. Harris ◽  
Harith M. Aljubori ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Replacement Therapy ◽  
End Stage Kidney Disease ◽  
Kidney Replacement Therapy ◽  
End Stage

scholarly journals The unaccomplished mission of reducing mortality in patients on kidney replacement therapy

2020 ◽  
Vol 13 (6) ◽  
pp. 948-951
Author(s):  
Alberto Ortiz
Keyword(s):  
Risk Factors ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Early Death ◽  
Gene Encoding ◽  
Mineral And Bone Disorder ◽  
Transplant Patients ◽  
Kidney Replacement Therapy ◽  
End Stage ◽  
The Impact

Abstract Six years ago, a comprehensive review by the EURECA-m working group of the ERA-EDTA thoroughly addressed the drivers of mortality in patients with end-stage kidney disease. Not unexpectedly, the key global driver of early death in these patients was the lack of access to kidney replacement therapy. However, and contrary to the expectations of non-nephrologists, mortality was still high when kidney replacement therapy was provided. This was due to excess cardiovascular and non-cardiovascular mortality, and the need to further characterize correctable risk factors and eventually test the impact of correcting them was emphasized. In this issue of ckj, seven reports address risk factors for death in non-dialysis chronic kidney disease (CKD), dialysis and kidney transplant patients. They characterize irreversible (e.g. sex; age; genetic variants of the KL gene encoding the anti-ageing protein Klotho) and reversible (obesity; mineral and bone disorder parameters; anti-depressant drugs, especially those that increase the QT; amputation; public health investments) factors associated with mortality of CKD patients on or off kidney replacement therapy.

scholarly journals Global Epidemiology of End-Stage Kidney Disease and Disparities in Kidney Replacement Therapy

2021 ◽  
pp. 1-10
Author(s):  
John S. Thurlow ◽  
Megha Joshi ◽  
Guofen Yan ◽  
Keith C. Norris ◽  
Lawrence Y. Agodoa ◽  
...  
Keyword(s):  
Health Care ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Practice Patterns ◽  
Care Delivery ◽  
End Stage Kidney Disease ◽  
Global Epidemiology ◽  
Kidney Replacement Therapy ◽  
End Stage ◽  
Population Demographic

Background: The global epidemiology of end-stage kidney disease (ESKD) reflects each nation’s unique genetic, environmental, lifestyle, and sociodemographic characteristics. The response to ESKD, particularly regarding kidney replacement therapy (KRT), depends on local disease burden, culture, and socioeconomics. Here, we explore geographic variation and global trends in ESKD incidence and prevalence and examine variations in KRT modality, practice patterns, and mortality. We conclude with a discussion on disparities in access to KRT and strategies to reduce ESKD global burden and to improve access to treatment in low- and middle-income countries (LMICs). Summary: From 2003 to 2016, incidence rates of treated ESKD were relatively stable in many higher income countries but rose substantially predominantly in East and Southeast Asia. The prevalence of treated ESKD has increased worldwide, likely due to improving ESKD survival, population demographic shifts, higher prevalence of ESKD risk factors, and increasing KRT access in countries with growing economies. Unadjusted 5-year survival of ESKD patients on KRT was 41% in the USA, 48% in Europe, and 60% in Japan. Dialysis is the predominant KRT in most countries, with hemodialysis being the most common modality. Variations in dialysis practice patterns account for some of the differences in survival outcomes globally. Worldwide, there is a greater prevalence of KRT at higher income levels, and the number of people who die prematurely because of lack of KRT access is estimated at up to 3 times higher than the number who receive treatment. Key Messages: Many people worldwide in need of KRT as a life-sustaining treatment do not receive it, mostly in LMICs where health care resources are severely limited. This large treatment gap demands a focus on population-based prevention strategies and development of affordable and cost-effective KRT. Achieving global equity in KRT access will require concerted efforts in advocating effective public policy, health care delivery, workforce capacity, education, research, and support from the government, private sector, nongovernmental, and professional organizations.

Sign in / Sign up

Export Citation Format

Share Document