TY - JOUR
T1 - International Society of Nephrology Global Kidney Health Atlas
T2 - structures, organization, and services for the management of kidney failure in Western Europe
AU - ISN Western Europe Regional Board
AU - Kelly, Dearbhla M.
AU - Anders, Hans Joachim
AU - Bello, Aminu K.
AU - Choukroun, Gabriel
AU - Coppo, Rosanna
AU - Dreyer, Gavin
AU - Eckardt, Kai Uwe
AU - Johnson, David W.
AU - Jha, Vivekanand
AU - Harris, David C.H.
AU - Levin, Adeera
AU - Lunney, Meaghan
AU - Luyckx, Valerie
AU - Marti, Hans Peter
AU - Messa, Piergiorgio
AU - Mueller, Thomas F.
AU - Saad, Syed
AU - Stengel, Benedicte
AU - Vanholder, Raymond C.
AU - Weinstein, Talia
AU - Khan, Maryam
AU - Zaidi, Deenaz
AU - Osman, Mohamed A.
AU - Ye, Feng
AU - Tonelli, Marcello
AU - Okpechi, Ikechi G.
AU - Rondeau, Eric
N1 - Funding Information:
K-UE reports grants from Astra Zeneca, Bayer, Fresenius, and Vifor, during the conduct of the study; personal fees from Akebia, Bayer, Fresenius, and Vifor and grants from Amgen, Genzyme, and Shire, outside the submitted work. DWJ reports grants and personal fees from Baxter Healthcare and Fresenius Medical Care, travel sponsorship from Amgen, personal fees from Astra Zeneca, AWAK, and Ono, and grants from National Health and Medical Research Council of Australia, outside the submitted work. VJ reports grants from GlaxoSmithKline and Baxter Healthcare, provides scientific leadership to George Clinical, and consultancy fees for Biocon, Zudis Cadilla, and NephroPlus, all paid to his institution, outside the submitted work. ER reports personal fees and nonfinancial support from Alexion Pharmaceuticals, outside the submitted work. All the other authors declared no competing interests.
Funding Information:
This article is published as part of a supplement supported by the International Society of Nephrology (ISN; grant RES0033080 to the University of Alberta).
Funding Information:
This article is published as part of a supplement supported by the International Society of Nephrology (ISN; grant RES0033080 to the University of Alberta). The ISN provided administrative support for the design and implementation of the study and data collection activities. The authors were responsible for data management, analysis, and interpretation, as well as manuscript preparation, review, and approval, and the decision to submit the manuscript for publication. We thank Kara Stephenson Gehman in International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA)for carefully editing the English text of a draft of this manuscript. We thank Jo-Ann Donner, Coordinator at the ISN, for her prominent role and leadership in the manuscript management, editorial reviews, and submission process to Kidney International Supplements, Sandrine Damster, Senior Research Project Manager at the ISN, and Alberta Kidney Disease Network staff (Ghenette Houston, Sue Szigety, and Sophanny Tiv) for helping to organize and conduct the survey and for providing project management support. We also thank the ISN headquarters staff including the Executive Director, Charu Malik, and the Advocacy team. We also appreciate the support from the ISN's Executive Committee, regional leadership, and Affiliated Society leaders at the regional and country levels for their help with the ISN-GKHA survey.
Publisher Copyright:
© 2021 International Society of Nephrology
PY - 2021/5
Y1 - 2021/5
N2 - Populations in the high-income countries of Western Europe are aging due to increased life expectancy. As the prevalence of diabetes and obesity has increased, so has the burden of kidney failure. To determine the global capacity for kidney replacement therapy and conservative kidney management, the International Society of Nephrology conducted multinational, cross-sectional surveys and published the findings in the International Society of Nephrology Global Kidney Health Atlas. In the second iteration of the International Society of Nephrology Global Kidney Health Atlas, we aimed to describe the availability, accessibility, quality, and affordability of kidney failure care in Western Europe. Among the 29 countries in Western Europe, 21 (72.4%) responded, representing 99% of the region's population. The burden of kidney failure prevalence varied widely, ranging from 760 per million population (pmp) in Iceland to 1612 pmp in Portugal. Coverage of kidney replacement therapy from public funding was nearly universal, with the exceptions of Germany and Liechtenstein where part of the costs was covered by mandatory insurance. Fourteen (67%) of 21 countries charged no fees at the point of care delivery, but in 5 countries (24%), patients do pay some out-of-pocket costs. Long-term dialysis services (both hemodialysis and peritoneal dialysis) were available in all countries in the region, and kidney transplantation services were available in 19 (90%) countries. The incidence of kidney transplantation varied widely between countries from 12 pmp in Luxembourg to 70.45 pmp in Spain. Conservative kidney care was available in 18 (90%) of 21 countries. The median number of nephrologists was 22.9 pmp (range: 9.47–55.75 pmp). These data highlight the uniform capacity of Western Europe to provide kidney failure care, but also the scope for improvement in disease prevention and management, as exemplified by the variability in disease burden and transplantation rates.
AB - Populations in the high-income countries of Western Europe are aging due to increased life expectancy. As the prevalence of diabetes and obesity has increased, so has the burden of kidney failure. To determine the global capacity for kidney replacement therapy and conservative kidney management, the International Society of Nephrology conducted multinational, cross-sectional surveys and published the findings in the International Society of Nephrology Global Kidney Health Atlas. In the second iteration of the International Society of Nephrology Global Kidney Health Atlas, we aimed to describe the availability, accessibility, quality, and affordability of kidney failure care in Western Europe. Among the 29 countries in Western Europe, 21 (72.4%) responded, representing 99% of the region's population. The burden of kidney failure prevalence varied widely, ranging from 760 per million population (pmp) in Iceland to 1612 pmp in Portugal. Coverage of kidney replacement therapy from public funding was nearly universal, with the exceptions of Germany and Liechtenstein where part of the costs was covered by mandatory insurance. Fourteen (67%) of 21 countries charged no fees at the point of care delivery, but in 5 countries (24%), patients do pay some out-of-pocket costs. Long-term dialysis services (both hemodialysis and peritoneal dialysis) were available in all countries in the region, and kidney transplantation services were available in 19 (90%) countries. The incidence of kidney transplantation varied widely between countries from 12 pmp in Luxembourg to 70.45 pmp in Spain. Conservative kidney care was available in 18 (90%) of 21 countries. The median number of nephrologists was 22.9 pmp (range: 9.47–55.75 pmp). These data highlight the uniform capacity of Western Europe to provide kidney failure care, but also the scope for improvement in disease prevention and management, as exemplified by the variability in disease burden and transplantation rates.
KW - chronic kidney disease
KW - dialysis
KW - end-stage kidney disease
KW - kidney failure
KW - kidney registries
KW - kidney transplantation
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U2 - 10.1016/j.kisu.2021.01.007
DO - 10.1016/j.kisu.2021.01.007
M3 - Review article
AN - SCOPUS:85103981591
VL - 11
SP - e106-e118
JO - Kidney International Supplements
JF - Kidney International Supplements
SN - 2157-1724
IS - 2
ER -