Kidney international supplements · 2020
Considerations on equity in management of end-stage kidney disease in low- and middle-income countries.
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Van Biesen Wim, Jha Vivekanand, Abu-Alfa Ali K, Andreoli Sharon P, Ashuntantang Gloria, Bernieh Bassam, Brown Edwina, Chen Yuqing, Coppo Rosanna, Couchoud Cecile, Cullis Brett, Douthat Walter, Eke Felicia U, Hemmelgarn Brenda, Hou Fan Fan, Levin Nathan W, Luyckx Valerie A, Morton Rachael L, Moosa Mohammed Rafique, Murtagh Fliss E M, Richards Marie, Rondeau Eric, Schneditz Daniel, Shah Kamal D, Tesar Vladimir, Yeates Karen, Garcia Garcia Guillermo
Аннотация
Achievement of equity in health requires development of a health system in which everyone has a fair opportunity to attain their full health potential. The current, large country-level variation in the reported incidence and prevalence of treated end-stage kidney disease indicates the existence of system-level inequities. Equitable implementation of kidney replacement therapy (KRT) programs must address issues of availability, affordability, and acceptability. The major structural factors that impact equity in KRT in different countries are the organization of health systems, overall health care spending, funding and delivery models, and nature of KRT prioritization (transplantation, hemodialysis or peritoneal dialysis, and conservative care). Implementation of KRT programs has the potential to exacerbate inequity unless equity is deliberately addressed. In this review, we summarize discussions on equitable provision of KRT in low- and middle-income countries and suggest areas for future research.