GLOBAL DISPARITIES IN KIDNEY CARE: INEQUITIES IN ACCESS TO DIALYSIS, TRANSPLANTATION, AND EMERGING INNOVATIONS

Abstract

End-stage kidney disease and chronic kidney disease are rapidly becoming a health burden to the world and there are notable differences between the accessibility of diagnosis, treatment and long-term care across regions and populations. Despite the fact that much has been done to improve nephrology, accessibility to life-sustaining dialysis and kidney transplantation is not well spread out, particularly in low- and middle-income nations and in such socially deprived groups of high-income areas. It is a summary of the current findings of the inequalities in kidney care worldwide with a specific emphasis on the inequity in the provision of dialysis, kidney transplantation, and the new developments of the care continuum. The review is based on peer-reviewed sources, the global registry data, and the reports on the latest efforts to enhance nephrology in various countries to explore the disparity in the burden of the disease, the ability of healthcare facilities, the funding, and the supply of the workforce that characterizes the access to and outcomes regarding the world. Accessibility to dialysis, modality, quality, and transplantation rates are discussed according to structural and social factors, i.e., socioeconomic status, geographical location, and politics. The evaluation of the possibility of emerging innovations, such as home-based dialysis, transplant technologies, nephroprotective therapies, and diagnostic tools, to improve equity, is also provided, with risks of widening the disparity being the unequal implementation. The findings reveal that to reduce the disparities in kidney care across the globe, the system level interventions that include early disease detection, long-term financing, human resource and fair distribution of innovations must be implemented. Equity should be embedded in the kidney care planning and research as one of the core elements to improve the health of the kidney of the entire world.