Disparities in kidney care in vulnerable populations: A multinational study from the ISN-GKHA

• DOI: 10.1371/journal.pgph.0004086
• Publication Date: 2024-12-20T18:31:54Z
• Authors: Robin L. Erickson; Nivedita Kamath; Arpana Iyengar; Adebowale Ademola; Christopher Esezobor; Rowena Lalji; Erin Hedin; Silvia Arruebo; Fergus J. Caskey; Sandrine Damster; Jo-Ann Donner; Vivekanand Jha; Adeera Levin; Masaomi Nangaku; Syed Saad; Marcello Tonelli; Feng Ye; Ikechi G. Okpechi; Aminu K. Bello; David W. Johnson
• Keywords: Nephrology; Internally displaced person; Global Health

Vulnerable populations, such as the elderly, children, displaced people, and refugees, often encounter challenges in accessing healthcare. In this study, we used data from third iteration of International Society Nephrology Global Kidney Health Atlas (ISN-GKHA) to describe kidney care access delivery vulnerable populations across countries regions. Using an international survey clinicians, policymakers, patient advocates, assessed funding coverage on all aspects replacement therapies (KRT). Overall, 167 or jurisdictions participated survey, representing 97.4% world’s population. Children had less than adults KRT: hemodialysis (HD) 74% countries, peritoneal dialysis (PD) 53% transplantation (KT) 80% countries. Available nephrologist workforce for pediatric was much lower (0.69 per million population [pmp] vs 10.08 pmp). Refugees people with failure did not have HD, PD, KT 21%, 33%, 37% participating respectively. Low-income (LICs) were likely provide KRT refugees compared high-income (HICs): HD: 13% 22%; PD: 19% 61%; KT: 30% 44%. Testing disease routinely offered elderly only 61% countries: LICs (45%), lower-middle-income (56%), upper-middle-income (54%), HICs (75%). Equitable particularly children remains area unmet need. Strategies are needed address issue.