Capacity for the management of kidney failure in the International Society of Nephrology North America and the Caribbean region: Report from the 2023 ISN Global Kidney Health Atlas (ISN-GKHA)

Racquel Lowe-Jones*, Isabelle Ethier*, Lori-Ann Fisher, Michelle M.Y. Wong, Stephanie Thompson, Fergus J Caskey, et al

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

1 Citation (Scopus)
12 Downloads (Pure)

Abstract

The International Society of Nephrology Global Kidney Health Atlas charts the availability and capacity of kidney care globally. In the North America and the Caribbean region, the Atlas can identify opportunities for kidney care improvement particularly in Caribbean countries where structures for systematic data collection are lacking. In this third iteration, respondents from 12 of 18 countries from the region reported a 2-fold higher than global median prevalence of dialysis and transplant, and a 3-fold higher than global median prevalence of dialysis centers. Peritoneal dialysis prevalence was lower than global median, and transplantation data was missing from 6 of the 10 Caribbean countries. Government-funded payments predominated for dialysis modalities, with greater heterogeneity in transplantation payor mix. Services for chronic kidney disease (CKD), such as monitoring of anemia and blood pressure, and diagnostic capability relying on serum creatinine and urinalyses were universally available. Notable exceptions in Caribbean countries included non-calcium-based phosphate binders and kidney biopsy services. Personnel shortages were reported across the region. Kidney failure was more commonly identified as a governmental priority than was CKD or acute kidney injury. In this generally affluent region, there is better access to kidney replacement therapy and CKD-related services than in much of the world. Yet clear heterogeneity exists, especially among the Caribbean countries struggling with dialysis and personnel capacity. Important steps to improve kidney care in the region include increased emphasis on preventive care, a focus on home-based modalities and transplantation, and solutions to train and retain specialized allied health professionals.
Original languageEnglish
Pages (from-to)83-96
Number of pages14
JournalKidney International Supplements
Volume13
Issue number1
Early online date8 Apr 2024
DOIs
Publication statusPublished - 8 Apr 2024

Bibliographical note

Publisher Copyright:
© 2024 International Society of Nephrology

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