TY - JOUR
T1 - Capacity for the management of kidney failure in the International Society of Nephrology South Asia region
T2 - report from the 2023 ISN Global Kidney Health Atlas (ISN-GKHA)
AU - Regional Board and ISN-GKHA Team Authors
AU - Wijewickrama, Eranga
AU - Alam, Muhammad Rafiqul
AU - Bajpai, Divya
AU - Divyaveer, Smita
AU - Iyengar, Arpana
AU - Kumar, Vivek
AU - Qayyum, Ahad
AU - Yadav, Shankar Prasad
AU - Yadla, Manjusha
AU - Arruebo, Silvia
AU - Bello, Aminu K.
AU - Caskey, Fergus J.
AU - Damster, Sandrine
AU - Donner, Jo Ann
AU - Jha, Vivekanand
AU - Johnson, David W.
AU - Levin, Adeera
AU - Malik, Charu
AU - Nangaku, Masaomi
AU - Okpechi, Ikechi G.
AU - Tonelli, Marcello
AU - Ye, Feng
AU - Singh Shah, Dibya
AU - Prasad, Narayan
AU - Agarwal, Anil K.
AU - Ahmed, Ejaz
AU - Alexander, Suceena
AU - Amouzegar, Atefeh
AU - Anandh, Urmila
AU - Bansal, Shyam Bihari
AU - Chhetri, Pramod Kumar
AU - Cho, Yeoungjee
AU - Choden, Ugyen
AU - Chowdury, Nizamuddin
AU - Conjeevaram, Arvind
AU - Davids, M. Razeen
AU - Davison, Sara N.
AU - Diongole, Hassane M.
AU - Ekrikpo, Udeme E.
AU - Ethier, Isabelle
AU - Mervin, Edwin Fernando
AU - Wing-Shing Fung, Winston
AU - George, Reena Rachel
AU - Ghimire, Anukul
AU - Gopal, Basu
AU - Guditi, Swarnalatha
AU - Herath, Chula
AU - Houston, Ghenette
AU - Htay, Htay
AU - Irish, Georgina
N1 - Publisher Copyright:
© 2024 International Society of Nephrology
PY - 2024/4
Y1 - 2024/4
N2 - The South Asia region is facing a high burden of chronic kidney disease (CKD) with limited health resources and low expenditure on health care. In addition to the burden of CKD and kidney failure from traditional risk factors, CKD of unknown etiologies from India and Sri Lanka compounds the challenges of optimal management of CKD in the region. From the third edition of the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA), we present the status of CKD burden, infrastructure, funding, resources, and health care personnel using the World Health Organization's building blocks for health systems in the ISN South Asia region. The poor status of the public health care system and low health care expenditure resulted in high out-of-pocket expenditures for people with kidney disease, which further compounded the situation. There is insufficient country capacity across the region to provide kidney replacement therapies to cover the burden. The infrastructure was also not uniformly distributed among the countries in the region. There were no chronic hemodialysis centers in Afghanistan, and peritoneal dialysis services were only available in Bangladesh, India, Nepal, Pakistan, and Sri Lanka. Kidney transplantation was not available in Afghanistan, Bhutan, and Maldives. Conservative kidney management was reported as available in 63% (n = 5) of the countries, yet no country reported availability of the core CKM care components. There was a high hospitalization rate and early mortality because of inadequate kidney care. The lack of national registries and actual disease burden estimates reported in the region prevent policymakers’ attention to CKD as an important cause of morbidity and mortality. Data from the 2023 ISN-GKHA, although with some limitations, may be used for advocacy and improving CKD care in the region.
AB - The South Asia region is facing a high burden of chronic kidney disease (CKD) with limited health resources and low expenditure on health care. In addition to the burden of CKD and kidney failure from traditional risk factors, CKD of unknown etiologies from India and Sri Lanka compounds the challenges of optimal management of CKD in the region. From the third edition of the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA), we present the status of CKD burden, infrastructure, funding, resources, and health care personnel using the World Health Organization's building blocks for health systems in the ISN South Asia region. The poor status of the public health care system and low health care expenditure resulted in high out-of-pocket expenditures for people with kidney disease, which further compounded the situation. There is insufficient country capacity across the region to provide kidney replacement therapies to cover the burden. The infrastructure was also not uniformly distributed among the countries in the region. There were no chronic hemodialysis centers in Afghanistan, and peritoneal dialysis services were only available in Bangladesh, India, Nepal, Pakistan, and Sri Lanka. Kidney transplantation was not available in Afghanistan, Bhutan, and Maldives. Conservative kidney management was reported as available in 63% (n = 5) of the countries, yet no country reported availability of the core CKM care components. There was a high hospitalization rate and early mortality because of inadequate kidney care. The lack of national registries and actual disease burden estimates reported in the region prevent policymakers’ attention to CKD as an important cause of morbidity and mortality. Data from the 2023 ISN-GKHA, although with some limitations, may be used for advocacy and improving CKD care in the region.
KW - epidemiology
KW - Global Kidney Health Atlas
KW - International Society of Nephrology
KW - kidney failure
KW - kidney replacement therapy
KW - South Asia
UR - http://www.scopus.com/inward/record.url?scp=85189560968&partnerID=8YFLogxK
U2 - 10.1016/j.kisu.2024.01.007
DO - 10.1016/j.kisu.2024.01.007
M3 - Review article
AN - SCOPUS:85189560968
SN - 2157-1724
VL - 13
SP - 123
EP - 135
JO - Kidney International Supplements
JF - Kidney International Supplements
IS - 1
ER -