Increasing access to integrated ESKD care as part of Universal Health Coverage

Journal article

The global nephrology community recognizes the need for a cohesive strategy to address the growing problem of end-stage kidney disease (ESKD). In March 2018, the International Society of Nephrology hosted a summit on integrated ESKD care, including 92 individuals with diverse expertise and professional backgrounds from around the globe. The attendees were from 41 countries, including 16 participants from 11 low- and lower-middle-income countries. The purpose was to develop a strategic plan to improve worldwide access to integrated ESKD care, by identifying and prioritizing key activities across eight themes: Estimates of ESKD Burden and Treatment Coverage; Advocacy; Education and Training/Workforce; Financing/Funding Models; Ethics; Dialysis; Transplantation; and Conservative Care. Action plans with prioritized lists of goals, activities, and key deliverables, and an overarching performance framework were developed for each theme. Examples of these key deliverables include: improved data availability, integration of core registry measures and analysis to inform development of healthcare policy; a framework for advocacy; improved and continued stakeholder engagement; improved workforce training; equitable, efficient and cost-effective funding models; greater understanding and greater application of ethical principles in practice and policy; definition and application of standards for safe and sustainable dialysis treatment and a set of measurable quality parameters; and integration of dialysis, transplantation, and comprehensive conservative care as ESKD treatment options within the context of overall health priorities. Intended users of the action plans include clinicians, patients and their families, scientists, industry partners, government decision makers, and advocacy organizations. Implementation of this integrated and comprehensive plan is intended to improve quality and access to care and thereby reduce serious health-related suffering of adults and children affected by ESKD worldwide.

Authors: Jha, V; Harden, P; participants, I

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Elsevier
• Journal: Kidney International
• Volume: 95
• Issue: 4
• Pages: S1–S33
• Publication date: 2019-04-01
• Acceptance date: 2018-12-27
• DOI: 10.1016/j.kint.2018.12.005
• EISSN: 1523-1755
• ISSN: 0085-2538