Abstract
Background:
Worldwide, the uptake of peritoneal dialysis (PD) compared to hemodialysis remains limited. This study assessed organizational structures, availability, accessibility, affordability, and quality of PD worldwide.
Methods:
This cross-sectional study relied on data from kidney registries as well as survey data from stakeholders (clinicians, policymakers, and advocates for people living with kidney disease) from countries affiliated with the International Society of Nephrology (ISN) from July to September 2022.
Results:
Overall, 167 countries participated in the survey. PD was available in 79% of countries with a median global prevalence of 21.0 (interquartile range [IQR]: 1.5–62.4) per million population (pmp). High-income countries (HICs) had an 80-fold higher prevalence of PD than low-income countries (LICs) (56.2 pmp versus 0.7 pmp). In 53% of countries, adults had greater PD access than children. Only 40% of countries used public funding (and free) reimbursement for PD catheter insertion with Africa (15%), North and East Asia (17%), and Oceania and South East Asia (22%) having the lowest proportions of countries in this category. Overall, the annual median cost of PD was US$ 18,959.2 (IQR: US$ 10,891.4–US$ 31,013.8) with full private out-of-pocket payment in 4% of countries and the highest median cost in LICs (US$ 30,064.4) compared to other country income levels (e.g., HICs US$ 27,206.0).
Conclusions:
Ongoing large gaps and variability in the availability, access, and affordability of PD across countries and world regions were observed. Of note, there is significant inequity in access to PD by children and for people in LICs.
Worldwide, the uptake of peritoneal dialysis (PD) compared to hemodialysis remains limited. This study assessed organizational structures, availability, accessibility, affordability, and quality of PD worldwide.
Methods:
This cross-sectional study relied on data from kidney registries as well as survey data from stakeholders (clinicians, policymakers, and advocates for people living with kidney disease) from countries affiliated with the International Society of Nephrology (ISN) from July to September 2022.
Results:
Overall, 167 countries participated in the survey. PD was available in 79% of countries with a median global prevalence of 21.0 (interquartile range [IQR]: 1.5–62.4) per million population (pmp). High-income countries (HICs) had an 80-fold higher prevalence of PD than low-income countries (LICs) (56.2 pmp versus 0.7 pmp). In 53% of countries, adults had greater PD access than children. Only 40% of countries used public funding (and free) reimbursement for PD catheter insertion with Africa (15%), North and East Asia (17%), and Oceania and South East Asia (22%) having the lowest proportions of countries in this category. Overall, the annual median cost of PD was US$ 18,959.2 (IQR: US$ 10,891.4–US$ 31,013.8) with full private out-of-pocket payment in 4% of countries and the highest median cost in LICs (US$ 30,064.4) compared to other country income levels (e.g., HICs US$ 27,206.0).
Conclusions:
Ongoing large gaps and variability in the availability, access, and affordability of PD across countries and world regions were observed. Of note, there is significant inequity in access to PD by children and for people in LICs.
| Original language | English |
|---|---|
| Pages (from-to) | ii18–ii25 |
| Number of pages | 8 |
| Journal | Nephrology Dialysis Transplantation |
| Volume | 39 |
| Issue number | Supplement_2 |
| DOIs | |
| Publication status | Published - 5 Sept 2024 |
Bibliographical note
Publisher Copyright:© The Author(s) 2024.