Kidney International Supplements最新文献

{"title":"Mineralocorticoid receptor activation and antagonism in cardiovascular disease: cellular and molecular mechanisms.","authors":"J. Bauersachs, Achim Lother","doi":"10.1016/j.kisu.2021.11.001","DOIUrl":"https://doi.org/10.1016/j.kisu.2021.11.001","url":null,"abstract":"","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":"44 1","pages":"19-26"},"PeriodicalIF":5.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84894272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The renin-angiotensin system biomolecular cascade: a 2022 update of newer insights and concepts.","authors":"C. Ferrario, L. Groban, Hao Wang, Xuming Sun, Jessica L. Voncannon, Kendra N. Wright, Sarfaraz Ahmad","doi":"10.1016/j.kisu.2021.11.002","DOIUrl":"https://doi.org/10.1016/j.kisu.2021.11.002","url":null,"abstract":"","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":"101 1","pages":"36-47"},"PeriodicalIF":5.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76070610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in North America and the Caribbean","authors":"Aminu K. Bello ,&nbsp;Mark McIsaac ,&nbsp;Ikechi G. Okpechi ,&nbsp;David W. Johnson ,&nbsp;Vivekanand Jha ,&nbsp;David C.H. Harris ,&nbsp;Syed Saad ,&nbsp;Deenaz Zaidi ,&nbsp;Mohamed A. Osman ,&nbsp;Feng Ye ,&nbsp;Meaghan Lunney ,&nbsp;Kailash Jindal ,&nbsp;Scott Klarenbach ,&nbsp;Kamyar Kalantar-Zadeh ,&nbsp;Csaba P. Kovesdy ,&nbsp;Rulan S. Parekh ,&nbsp;Bhanu Prasad ,&nbsp;Maryam Khan ,&nbsp;Parnian Riaz ,&nbsp;Marcello Tonelli ,&nbsp;Adeera Levin","doi":"10.1016/j.kisu.2021.01.001","DOIUrl":"10.1016/j.kisu.2021.01.001","url":null,"abstract":"<div><p><span><span>The International Society of Nephrology established the Global Kidney Health Atlas project to define the global capacity for </span>kidney replacement therapy<span> and conservative kidney care, and this second iteration was to describe the availability, accessibility, quality, and affordability of kidney failure (KF) care worldwide. This report presents results for the International Society of Nephrology North America and the Caribbean region. Relative to other regions, the North America and Caribbean region had better infrastructure and funding for health care<span> and more health care workers relative to the population. Various essential medicines were also more available and accessible. There was substantial variation in the prevalence of treated KF in the region, ranging from 137.4 per million population (pmp) in Jamaica to 2196 pmp in the United States. A mix of public and private funding systems cover costs for nondialysis chronic kidney disease care in 60% of countries and for dialysis in 70% of countries. Although the median number of nephrologists is 18.1 (interquartile range, 15.3–29.5) pmp, which is approximately twice the global median of 9.9 (interquartile range, 1.2–22.7) pmp, some countries reported shortages of other health care workers. Dialysis was available in all countries, but </span></span></span>peritoneal dialysis<span> was underutilized and unavailable in Barbados, Cayman Islands, and Turks and Caicos. Kidney transplantation<span> was primarily available in Canada and the United States. Economic factors were the major barriers to optimal KF care in the Caribbean countries, and few countries in the region have chronic kidney disease–specific national health care policies. To address regional gaps in KF care delivery, efforts should be directed toward augmenting the workforce, improving the monitoring and reporting of kidney replacement therapy indicators, and implementing noncommunicable disease and chronic kidney disease–specific policies in all countries.</span></span></p></div>","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":"11 2","pages":"Pages e66-e76"},"PeriodicalIF":5.5,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.kisu.2021.01.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38986994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in Latin America","authors":"Marina Wainstein ,&nbsp;Aminu K. Bello ,&nbsp;Vivekanand Jha ,&nbsp;David C.H. Harris ,&nbsp;Adeera Levin ,&nbsp;Maria C. Gonzalez-Bedat ,&nbsp;Guillermo J. Rosa-Diez ,&nbsp;Alejandro Ferreiro Fuentes ,&nbsp;Laura Sola ,&nbsp;Roberto Pecoits-Filho ,&nbsp;Rolando Claure-Del Granado ,&nbsp;Magdalena Madero ,&nbsp;Mohamed A. Osman ,&nbsp;Syed Saad ,&nbsp;Deenaz Zaidi ,&nbsp;Meaghan Lunney ,&nbsp;Feng Ye ,&nbsp;Ivor J. Katz ,&nbsp;Maryam Khan ,&nbsp;Sally Shrapnel ,&nbsp;David W. Johnson","doi":"10.1016/j.kisu.2021.01.005","DOIUrl":"10.1016/j.kisu.2021.01.005","url":null,"abstract":"<div><p><span><span><span>Latin America is a region with a widely variable socioeconomic landscape, facing a surge in noncommunicable diseases<span>, including chronic kidney disease and kidney failure, exposing significant limitations in the delivery of care. Despite region-wide efforts to explore and address these limitations, much uncertainty remains as to the capacity, accessibility, and quality of kidney failure care in Latin America. Through this second iteration of the International Society of </span></span>Nephrology Global Kidney Health Atlas, we aimed to report on these indicators to provide a comprehensive map of kidney failure care in the region. Survey responses were received from 18 (64.2%) countries, representing 93.8% of the total population in Latin America. The median prevalence and incidence of treated kidney failure in Latin America were 715 and 157 per million population, respectively, the latter being higher than the global median (142 per million population), with Puerto Rico, Mexico, and El Salvador experiencing much of this growing burden. In most countries, public and private systems collectively funded most aspects of </span>kidney replacement therapy<span> (dialysis and transplantation) care, with patients incurring at least 1% to 25% of out-of-pocket costs. In most countries, &gt;90% of dialysis patients able to access kidney replacement therapy received hemodialysis (n = 11; 5 high income and 6 upper-middle income), and only a small minority began with </span></span>peritoneal dialysis (1%–10% in 67% of countries; n = 12). Few countries had chronic kidney disease registries or targeted detection programs. There is a large variability in the availability, accessibility, and quality of kidney failure care in Latin America, which appears to be subject to individual countries’ funding structures, underreliance on cheap kidney replacement therapy, such as peritoneal dialysis, and limited chronic kidney disease surveillance and management initiatives.</p></div>","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":"11 2","pages":"Pages e35-e46"},"PeriodicalIF":5.5,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.kisu.2021.01.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38986991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding distribution and variability in care organization and services for the management of kidney care across world regions","authors":"Aminu K. Bello ,&nbsp;Ikechi G. Okpechi ,&nbsp;Vivekanand Jha ,&nbsp;David C.H. Harris ,&nbsp;Adeera Levin ,&nbsp;David W. Johnson","doi":"10.1016/j.kisu.2021.01.010","DOIUrl":"10.1016/j.kisu.2021.01.010","url":null,"abstract":"","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":"11 2","pages":"Pages e4-e10"},"PeriodicalIF":5.5,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.kisu.2021.01.010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43658974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in South Asia","authors":"Smita S. Divyaveer ,&nbsp;Raja Ramachandran ,&nbsp;Manisha Sahay ,&nbsp;Dibya Singh Shah ,&nbsp;Fazal Akhtar ,&nbsp;Aminu K. Bello ,&nbsp;Arpana Iyengar ,&nbsp;David W. Johnson ,&nbsp;David C.H. Harris ,&nbsp;Adeera Levin ,&nbsp;Meaghan Lunney ,&nbsp;Muhibur Rahman ,&nbsp;Harun-Ur Rashid ,&nbsp;Syed Saad ,&nbsp;Deenaz Zaidi ,&nbsp;Mohamed A. Osman ,&nbsp;Santosh Varughese ,&nbsp;Eranga S. Wijewickrama ,&nbsp;Maryam Khan ,&nbsp;Feng Ye ,&nbsp;Vivekanand Jha","doi":"10.1016/j.kisu.2021.01.006","DOIUrl":"10.1016/j.kisu.2021.01.006","url":null,"abstract":"<div><p><span><span>Information about disease burden<span> and the available infrastructure and workforce to care for patients with kidney disease was collected for the second edition of the International Society of </span></span>Nephrology<span><span> Global Kidney Health Atlas. This paper presents findings for the 8 countries in the South Asia region. The World Bank categorizes Afghanistan and Nepal as low-income; Bangladesh, Bhutan, India, and Pakistan as lower-middle-income; and Sri Lanka and the Maldives as upper-middle-income countries. The prevalence of chronic kidney disease (CKD) in South Asia ranged from 5.01% to 13.24%. Long-term </span>hemodialysis and long-term </span></span>peritoneal dialysis<span> are available in all countries, but Afghanistan lacks peritoneal dialysis services. Kidney transplantation<span> was available in all countries except Bhutan and Maldives. Hemodialysis was the dominant modality of long-term dialysis, peritoneal dialysis was more expensive than hemodialysis, and kidney transplantation overwhelmingly depended on living donors. Bhutan provided public funding for kidney replacement therapy<span> (dialysis and transplantation); Sri Lanka, India, Pakistan, and Bangladesh had variable funding mechanisms; and Afghanistan relied solely on out-of-pocket expenditure. There were shortages of health care personnel across the entire region. Reporting was variable: Afghanistan and Sri Lanka have dialysis registries but publish no reports, whereas Bangladesh has a transplant registry. South Asia has a large, but poorly documented burden of CKD. Diabetes and hypertension are the major causes of CKD throughout the region with a higher prevalence of infectious causes in Afghanistan and a high burden of CKD of an unknown cause in Sri Lanka and parts of India. The extent and quality of care delivery is suboptimal and variable. Sustainable strategies need to be developed to address the growing burden of CKD in the region.</span></span></span></p></div>","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":"11 2","pages":"Pages e97-e105"},"PeriodicalIF":5.5,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.kisu.2021.01.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38976567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in the Middle East","authors":"Atefeh Amouzegar ,&nbsp;Ali K. Abu-Alfa ,&nbsp;Mona N. Alrukhaimi ,&nbsp;Aminu K. Bello ,&nbsp;Mohammad A. Ghnaimat ,&nbsp;David W. Johnson ,&nbsp;Vivekanand Jha ,&nbsp;David C.H. Harris ,&nbsp;Adeera Levin ,&nbsp;Marcello Tonelli ,&nbsp;Meaghan Lunney ,&nbsp;Syed Saad ,&nbsp;Maryam Khan ,&nbsp;Deenaz Zaidi ,&nbsp;Mohamed A. Osman ,&nbsp;Feng Ye ,&nbsp;Ikechi G. Okpechi ,&nbsp;Shahrzad Ossareh ,&nbsp;ISN Middle East Regional Board","doi":"10.1016/j.kisu.2021.01.002","DOIUrl":"10.1016/j.kisu.2021.01.002","url":null,"abstract":"<div><p>Kidney failure is the permanent impairment of kidney function associated with increased morbidity, hospitalization, and requirement for kidney replacement therapy<span>. A total of 11 countries in the Middle East region (84.6%) responded to the survey. The prevalence of chronic kidney disease<span><span><span> in the region ranged from 5.2% to 10.6%, whereas prevalence of treated kidney failure ranged from 152 to 826 per million population. Overall, the incidence of kidney transplantation<span> was highest in Iran (30.9 per million population) and lowest in Oman and the United Arab Emirates (2.2 and 3.0 per million population, respectively). Long-term hemodialysis services were available in all countries, long-term </span></span>peritoneal dialysis services were available in 9 (69.2%) countries, and transplantation services were available in most countries of the region. Public funding covered the costs of nondialysis chronic </span>kidney disease<span><span> care in two-thirds of countries, and kidney replacement therapy in nearly all countries. More than half of the countries had dialysis registries; however, national noncommunicable disease<span> strategies were lacking in most countries. The Middle East is a region with high burden of kidney disease and needs cost-effective measures through effective health care funding to be available to improve kidney care in the region. Furthermore, well-designed and sustainable </span></span>health information systems are needed in the region to address current gaps in kidney care in the region.</span></span></span></p></div>","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":"11 2","pages":"Pages e47-e56"},"PeriodicalIF":5.5,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.kisu.2021.01.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38986992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Society of Nephrology Global Kidney Health Atlas: structures, organization and services for the management of kidney failure in North and East Asia","authors":"Luxia Zhang ,&nbsp;Jinwei Wang ,&nbsp;Chih-Wei Yang ,&nbsp;Sydney Chi-wai Tang ,&nbsp;Naoki Kashihara ,&nbsp;Yong-soo Kim ,&nbsp;Ariunaa Togtokh ,&nbsp;Syed Saad ,&nbsp;Feng Ye ,&nbsp;Maryam Khan ,&nbsp;Deenaz Zaidi ,&nbsp;Mohamed A. Osman ,&nbsp;Meaghan Lunney ,&nbsp;Ikechi G. Okpechi ,&nbsp;Vivekanand Jha ,&nbsp;David C.H. Harris ,&nbsp;Adeera Levin ,&nbsp;Marcello Tonelli ,&nbsp;David W. Johnson ,&nbsp;Aminu K. Bello ,&nbsp;Ming-hui Zhao","doi":"10.1016/j.kisu.2021.01.011","DOIUrl":"10.1016/j.kisu.2021.01.011","url":null,"abstract":"<div><p>Kidney failure (KF) is a public health<span><span><span> problem in all regions of the world. We aim to provide comprehensive information regarding the disease burden of KF and capacity for providing optimal care in the International Society of </span>Nephrology<span> North and East Asia region based on data from the International Society of Nephrology Global Kidney Health Atlas project. Seven of eight jurisdictions participated, and wide variation was found in terms of KF burden and care capacity. Prevalence of long-term dialysis ranged from 88.4 per million population in mainland China to 3251 per million population in Taiwan. Hemodialysis was the predominant modality of dialysis in all jurisdictions, except for Hong Kong, where </span></span>peritoneal dialysis<span> (PD) was much more prevalent than hemodialysis. All jurisdictions provided public funding for kidney replacement therapy (dialysis and transplantation). Although the frequency and duration of hemodialysis followed a standard pattern in all investigated jurisdictions, the density of nephrologists and kidney replacement therapy centers varied according to income level. Conservative care, whether medically advised or chosen by patients, was available in most jurisdictions. All jurisdictions had official registries for KF and recognized KF as a health priority. These comprehensive data provide information about the burden of KF and capacity to provide optimal care in North and East Asia, which varied greatly across jurisdictions in the region.</span></span></p></div>","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":"11 2","pages":"Pages e77-e85"},"PeriodicalIF":5.5,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.kisu.2021.01.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38986995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in Newly Independent States and Russia","authors":"Elena Zakharova ,&nbsp;Abduzhappar Gaipov ,&nbsp;Aminu K. Bello ,&nbsp;David W. Johnson ,&nbsp;Vivekanand Jha ,&nbsp;David C.H. Harris ,&nbsp;Adeera Levin ,&nbsp;Syed Saad ,&nbsp;Maryam Khan ,&nbsp;Deenaz Zaidi ,&nbsp;Mohamed A. Osman ,&nbsp;Feng Ye ,&nbsp;Meaghan Lunney ,&nbsp;Marcello Tonelli ,&nbsp;Ikechi G. Okpechi ,&nbsp;Alexander Zemchenkov ,&nbsp;Irma Tchokhonelidze ,&nbsp;ISN Newly Independent States and Russia Regional Board","doi":"10.1016/j.kisu.2021.01.003","DOIUrl":"10.1016/j.kisu.2021.01.003","url":null,"abstract":"<div><p><span><span>The International Society of Nephrology<span> Global Kidney Health Atlas analyzed the current state of kidney care in Newly Independent States and Russia. Our results demonstrated that the Newly Independent States and Russia region was not an exception and showed the same effect of chronic kidney disease on health and its outcomes, facing many difficulties and challenges in terms of improving kidney care across the countries. This work summarized and presented demographics, </span></span>health information systems<span><span>, statistics, and national health policy of the region, as well as characteristics of the burden of chronic kidney disease and kidney failure (KF) of participating countries. Besides significant economic advancement in the region, the collected data revealed existing shortage in KF care providers, essential medications, and health product access for KF care. Moreover, there was low reporting of kidney replacement therapy<span> (dialysis and kidney transplantation) quality indicators and low capacity for long-term hemodialysis, </span></span>peritoneal dialysis<span>, and kidney transplantation. The financial issues and funding structures for KF care across the region needs strategic support for fundamental changes and further advancement. This article emphasizes the urgent need for further effective regional and international collaborations and partnership for establishment of </span></span></span>universal health care systems for KF management.</p></div>","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":"11 2","pages":"Pages e57-e65"},"PeriodicalIF":5.5,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.kisu.2021.01.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38986993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in Eastern and Central Europe","authors":"Alicja Dębska-Ślizień ,&nbsp;Aminu K. Bello ,&nbsp;David W. Johnson ,&nbsp;Vivekanand Jha ,&nbsp;David C.H. Harris ,&nbsp;Adeera Levin ,&nbsp;Marcello Tonelli ,&nbsp;Syed Saad ,&nbsp;Deenaz Zaidi ,&nbsp;Mohamed A. Osman ,&nbsp;Feng Ye ,&nbsp;Maryam Khan ,&nbsp;Meaghan Lunney ,&nbsp;Ikechi G. Okpechi ,&nbsp;Rumeyza Turan Kazancioglu ,&nbsp;ISN Eastern and Central Europe Regional Board","doi":"10.1016/j.kisu.2021.01.008","DOIUrl":"10.1016/j.kisu.2021.01.008","url":null,"abstract":"<div><p><span><span><span>Provision of adequate kidney care for patients with chronic kidney disease or kidney failure (KF) is costly and requires extensive resources. There is an inequality in the global distribution of wealth and resources needed to provide this care. In this second iteration of the International Society of </span>Nephrology<span> Global Kidney Health Atlas, we present data for countries in Eastern and Central Europe. In the region, the median prevalence of chronic kidney disease was 13.15% and treated KF was 764 per million population, respectively, slightly higher than the global median of 759 per million population. In most countries in the region, over 90% of dialysis patients were on hemodialysis and patients with a functioning graft represented less than one-third of total patients with treated KF. The median annual costs for maintenance hemodialysis were close to the global median, and public funding provided nearly universal coverage of the costs of </span></span>kidney replacement therapy. Nephrologists were primarily responsible for KF care. All countries had the capacity to provide long-term hemodialysis, and 95% had the capacity to provide </span>peritoneal dialysis<span><span>. Home hemodialysis was generally not available. </span>Kidney transplantation and conservative care were available across most of the region. Almost all countries had official dialysis and transplantation registries. Eastern and Central Europe is a region with a high burden of chronic kidney disease and variable capacity to deal with it. Insufficient funding and workforce shortages coupled with increasing comorbidities among aging patients and underutilization of cost-effective dialysis therapies such as peritoneal dialysis and kidney transplantation may compromise the quality of care for patients with KF. Some workforce shortages could be addressed by improving the organization of nephrological care in some countries of the region.</span></p></div>","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":"11 2","pages":"Pages e24-e34"},"PeriodicalIF":5.5,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.kisu.2021.01.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38986990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}