Inequities in kidney health and kidney care.


Journal

Nature reviews. Nephrology
ISSN: 1759-507X
Titre abrégé: Nat Rev Nephrol
Pays: England
ID NLM: 101500081

Informations de publication

Date de publication:
11 2023
Historique:
accepted: 11 07 2023
medline: 23 10 2023
pubmed: 15 8 2023
entrez: 14 8 2023
Statut: ppublish

Résumé

Health inequity refers to the existence of unnecessary and unfair differences in the ability of an individual or community to achieve optimal health and access appropriate care. Kidney diseases, including acute kidney injury and chronic kidney disease, are the epitome of health inequity. Kidney disease risk and outcomes are strongly associated with inequities that occur across the entire clinical course of disease. Insufficient investment across the spectrum of kidney health and kidney care is a fundamental source of inequity. In addition, social and structural inequities, including inequities in access to primary health care, education and preventative strategies, are major risk factors for, and contribute to, poorer outcomes for individuals living with kidney diseases. Access to affordable kidney care is also highly inequitable, resulting in financial hardship and catastrophic health expenditure for the most vulnerable. Solutions to these injustices require leadership and political will. The nephrology community has an important role in advocacy and in identifying and implementing solutions to dismantle inequities that affect kidney health.

Identifiants

pubmed: 37580571
doi: 10.1038/s41581-023-00745-6
pii: 10.1038/s41581-023-00745-6
doi:

Types de publication

Journal Article Review Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

694-708

Informations de copyright

© 2023. Springer Nature Limited.

Références

Kawachi, I., Subramanian, S. V. & Almeida-Filho, N. A glossary for health inequalities. J. Epidemiol. Community Health 56, 647–652 (2022).
doi: 10.1136/jech.56.9.647
World Health Organisation. Health Topics — Health Equity. https://www.who.int/health-topics/health-equity (2010).
Nicholas, S. B., Kalantar-Zadeh, K. & Norris, K. C. Socioeconomic disparities in chronic kidney disease. Adv. Chronic Kidney Dis. 22, 6–15 (2015).
pubmed: 25573507 pmcid: 4291541 doi: 10.1053/j.ackd.2014.07.002
Martin, D. E. et al. Ethical challenges in nephrology: a call for action. Nat. Rev. Nephrol. 16, 603–613 (2020).
pubmed: 32587403 doi: 10.1038/s41581-020-0295-4
The Health Foundation. A Communications Toolkit for People Working in Public Health. https://www.health.org.uk/publications/how-to-talk-about-the-building-blocks-of-health (2022).
Lynch, J. W., Kaplan, G. A. & Salonen, J. T. Why do poor people behave poorly? Variation in adult health behaviours and psychosocial characteristics by stages of the socioeconomic lifecourse. Soc. Sci. Med. 44, 809–819 (1997).
pubmed: 9080564 doi: 10.1016/S0277-9536(96)00191-8
Luyckx, V. A., Cherney, D. Z. I. & Bello, A. K. Preventing CKD in developed countries. Kidney Int. Rep. 5, 263–277 (2020).
pubmed: 32154448 doi: 10.1016/j.ekir.2019.12.003
Sawhney, S. et al. Care processes and outcomes of deprivation across the clinical course of kidney disease: findings from a high-income country with universal healthcare. Nephrol. Dial. Transpl. 38, 1170–1182 (2023).
doi: 10.1093/ndt/gfac224
Vanholder, R. et al. Reducing the costs of chronic kidney disease while delivering quality health care: a call to action. Nat. Rev. Nephrol. 13, 393–409 (2017).
pubmed: 28555652 doi: 10.1038/nrneph.2017.63
The International Society of Nephrology. Global Kidney Health Atlas. https://www.theisn.org/initiatives/global-kidney-health-atlas/ (2023).
Collaboration GBDCKD. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the global burden of disease study 2017. Lancet 395 709-733 (2020).
Minutolo, R. et al. Detection and awareness of moderate to advanced CKD by primary care practitioners: a cross-sectional study from Italy. Am. J. Kidney Dis. 52, 444–453 (2008).
pubmed: 18468747 doi: 10.1053/j.ajkd.2008.03.002
Levin, A. et al. Global kidney health 2017 and beyond: a roadmap for closing gaps in care, research, and policy. Lancet 390, 1888–1917 (2017).
pubmed: 28434650 doi: 10.1016/S0140-6736(17)30788-2
Matsushita, K. et al. Estimated glomerular filtration rate and albuminuria for prediction of cardiovascular outcomes: a collaborative meta-analysis of individual participant data. Lancet Diabetes Endocrinol. 3, 514–525 (2015).
pubmed: 26028594 pmcid: 4594193 doi: 10.1016/S2213-8587(15)00040-6
Thomas, B. et al. Global cardiovascular and renal outcomes of reduced GFR. J. Am. Soc. Nephrol. 28, 2167–2179 (2017).
pubmed: 28408440 pmcid: 5491277 doi: 10.1681/ASN.2016050562
Luyckx, V. A. Equity is key to build back better after COVID-19: prioritize noncommunicable diseases and kidney health. Kidney360 2, 747–750 (2021).
pubmed: 35373045 pmcid: 8791323 doi: 10.34067/KID.0006932020
Vanholder, R. et al. Fighting the unbearable lightness of neglecting kidney health: the decade of the kidney. Clin. Kidney J. 14, 1719–1730 (2021).
pubmed: 34221379 pmcid: 8243275 doi: 10.1093/ckj/sfab070
European Commission. Research and Innovation. https://ec.europa.eu/info/research-and-innovation/research-area/health-research-and-innovation_en (accessed 31 July 2023).
World Health Organisation Europe. Health topics. https://www.who.int/europe/health-topics (accessed 31 July 2023).
EuroHealthNet. EuroHealthNet provides input for the EU NCD initiative. “Healthier Together”. https://eurohealthnet.eu/publication/eurohealthnet-provides-input-for-the-eu-ncd-initiative-healthier-together/?gclid=CjwKCAjwpKyYBhB7EiwAU2Hn2X2DCd8zG1iKjcvo8EsmpZmOhfnEcqmgzQd9egkTXxml5HMr451FdBoCbmAQAvD_BwE (2022).
NHS. Understanding what the public know about about their kidneys and what they do. thinkkidneys.nhs.uk, http://www.thinkkidneys.nhs.uk/aki/wp-content/uploads/sites/2/2015/01/Understanding-what-the-public-know-about-their-kidneys-and-what-they-do.pdf (2022).
Tonelli, M. et al. Risk of coronary events in people with chronic kidney disease compared with those with diabetes: a population-level cohort study. Lancet 380, 807–814 (2012).
pubmed: 22717317 doi: 10.1016/S0140-6736(12)60572-8
IHME. https://vizhub.healthdata.org/gbd-results .
Institute for Health Metrics and Evaluation. Global Burden of Disease Results. https://vizhub.healthdata.org/gbd-results/ (2019).
Liyanage, T. et al. Worldwide access to treatment for end-stage kidney disease: a systematic review. Lancet 385, 1975–1982 (2015).
pubmed: 25777665 doi: 10.1016/S0140-6736(14)61601-9
Lewington, A. J., Cerda, J. & Mehta, R. L. Raising awareness of acute kidney injury: a global perspective of a silent killer. Kidney Int. 84, 457–467 (2013).
pubmed: 23636171 pmcid: 3758780 doi: 10.1038/ki.2013.153
Luyckx, V. Getting chronic kidney disease on the map. NSAP 22, 115–120 (2022).
Mehta, R. L. et al. International Society of Nephrology’s 0by25 initiative for acute kidney injury (zero preventable deaths by 2025): a human rights case for nephrology. Lancet 385, 2616–2643 (2015).
pubmed: 25777661 doi: 10.1016/S0140-6736(15)60126-X
Mora, C. et al. Over half of known human pathogenic diseases can be aggravated by climate change. Nat. Clim. Chang. 12, 869–875 (2022).
pubmed: 35968032 pmcid: 9362357 doi: 10.1038/s41558-022-01426-1
Mills, K. T. et al. A systematic analysis of worldwide population-based data on the global burden of chronic kidney disease in 2010. Kidney Int. 88, 950–957 (2015).
pubmed: 26221752 pmcid: 4653075 doi: 10.1038/ki.2015.230
Lameire, N. The definitions and staging systems of acute kidney injury and their limitations in practice. Arab. J. Nephrol. Transpl. 6, 145–152 (2013).
Susantitaphong, P. et al. World incidence of AKI: a meta-analysis. Clin. J. Am. Soc. Nephrol. 8, 1482–1493 (2013).
pubmed: 23744003 pmcid: 3805065 doi: 10.2215/CJN.00710113
Institute for Health Metrics and Evaluation. Global Burden of Disease - Compare. https://vizhub.healthdata.org/gbd-compare (2020).
Vart, P., Reijneveld, S. A., Bultmann, U. & Gansevoort, R. T. Added value of screening for CKD among the elderly or persons with low socioeconomic status. Clin. J. Am. Soc. Nephrol. 10, 562–570 (2015).
pubmed: 25779994 pmcid: 4386261 doi: 10.2215/CJN.09030914
van Rijn, M. H. C., Alencar de Pinho, N., Wetzels, J. F., van den Brand, J. & Stengel, B. Worldwide disparity in the relation between CKD prevalence and kidney failure risk. Kidney Int. Rep. 5, 2284–2291 (2020).
pubmed: 33305122 pmcid: 7710841 doi: 10.1016/j.ekir.2020.09.040
Xie, Y. et al. Analysis of the Global Burden of Disease study highlights the global, regional, and national trends of chronic kidney disease epidemiology from 1990 to 2016. Kidney Int. 94, 567–581 (2018).
pubmed: 30078514 doi: 10.1016/j.kint.2018.04.011
Sever, M. et al. A roadmap for optimizing chronic kidney disease patient care and patient-oriented research in the Eastern European nephrology community. Clin. Kidney J. 14, 23–35 (2020).
pubmed: 33570513 pmcid: 7857792 doi: 10.1093/ckj/sfaa218
de Jong, R. W. et al. Results of the European EDITH nephrologist survey on factors influencing treatment modality choice for end-stage kidney disease. Nephrol. Dial. Transpl. 37, 126–38 (2021).
doi: 10.1093/ndt/gfaa342
Lunney, M. et al. Availability, accessibility, and quality of conservative kidney management worldwide. Clin. J. Am. Soc. Nephrol. 16, 79–87 (2020).
pubmed: 33323461 pmcid: 7792657 doi: 10.2215/CJN.09070620
Kevin Tucker, J. Social justice as a tool to eliminate inequities in kidney disease. Semin. Nephrol. 41, 203–10 (2021).
pubmed: 34330360 doi: 10.1016/j.semnephrol.2021.05.001
Etheredge, H. & Fabian, J. Challenges in expanding access to dialysis in South Africa-expensive modalities, cost constraints and human rights. Healthcare 5, 38 (2017).
pubmed: 28758959 pmcid: 5618166 doi: 10.3390/healthcare5030038
The World Bank. Gini index. data.worldbank.org, https://data.worldbank.org/indicator/SI.POV.GINI (2023).
Institute for Health Metrics and Evaluation. Epi Visualization, https://vizhub.healthdata.org/epi/ (2019).
Ashuntantang, G. et al. Outcomes in adults and children with end-stage kidney disease requiring dialysis in sub-Saharan Africa: a systematic review. Lancet Glob. Health 5, e408–e417 (2017).
pubmed: 28229924 doi: 10.1016/S2214-109X(17)30057-8
Caskey, F. J. et al. Global variation in renal replacement therapy for end-stage renal disease. Nephrol. Dial. Transpl. 26, 2604–2610 (2011).
doi: 10.1093/ndt/gfq781
Stel, V. S. et al. Supplemented ERA-EDTA Registry data evaluated the frequency of dialysis, kidney transplantation, and comprehensive conservative management for patients with kidney failure in Europe. Kidney Int. 100, 182–195 (2021).
pubmed: 33359055 doi: 10.1016/j.kint.2020.12.010
Norton, J. M. et al. Social determinants of racial disparities in CKD. J. Am. Soc. Nephrol. 27, 2576–2595 (2016).
pubmed: 27178804 pmcid: 5004663 doi: 10.1681/ASN.2016010027
Htay, H. et al. Global access of patients with kidney disease to health technologies and medications: findings from the Global Kidney Health Atlas project. Kidney Int. Suppl. 8, 64–73 (2018).
doi: 10.1016/j.kisu.2017.10.010
Francis, A. et al. Barriers to accessing essential medicines for kidney disease in low- and lower middle-income countries. Kidney Int. 102, 969–973 (2022).
pubmed: 36044940 doi: 10.1016/j.kint.2022.07.029
Sharif, M. U., Elsayed, M. E. & Stack, A. G. The global nephrology workforce: emerging threats and potential solutions! Clin. Kidney J. 9, 11–22 (2016).
pubmed: 26798456 doi: 10.1093/ckj/sfv111
Kalantar-Zadeh, K. et al. Living well with kidney disease by patient and care-partner empowerment: kidney health for everyone everywhere. Kidney Int. 99, 278–284 (2021).
pubmed: 33509344 doi: 10.1016/j.kint.2020.11.004
Carter, S. A. et al. Identifying outcomes important to patients with glomerular disease and their caregivers. Clin. J. Am. Soc. Nephrol. 15, 673–684 (2020).
pubmed: 32354728 pmcid: 7269216 doi: 10.2215/CJN.13101019
Morton, R. L. et al. Impact of CKD on household income. Kidney Int. Rep. 3, 610–618 (2018).
pubmed: 29854968 doi: 10.1016/j.ekir.2017.12.008
Garcia-Garcia, G. et al. Chronic kidney disease (CKD) in disadvantaged populations. Clin. Kidney J. 8, 3–6 (2015).
pubmed: 25713703 doi: 10.1093/ckj/sfu124
Banerjee, T. et al. Food insecurity, CKD, and subsequent ESRD in US adults. Am. J. Kidney Dis. 70, 38–47 (2017).
pubmed: 28215947 pmcid: 5765854 doi: 10.1053/j.ajkd.2016.10.035
Wilkinson, E., Brettle, A., Waqar, M. & Randhawa, G. Inequalities and outcomes: end stage kidney disease in ethnic minorities. BMC Nephrol. 20, 234 (2097).
doi: 10.1186/s12882-019-1410-2
Mohottige, D., Diamantidis, C. J., Norris, K. C. & Boulware, L. E. Racism and kidney health: turning equity into a reality. Am. J. Kidney Dis. 77, 951–962 (2021).
pubmed: 33639186 doi: 10.1053/j.ajkd.2021.01.010
Mohottige, D. & Lunn, M. R. Advancing equity in nephrology: enhancing care for LGBTQ+ patients and our workforce. Clin. J. Am. Soc. Nephrol. 14, 1094–1096 (2019).
pubmed: 31118212 pmcid: 6625618 doi: 10.2215/CJN.01950219
Norris, K. C. & Beech, B. M. Social determinants of kidney health: focus on poverty. Clin. J. Am. Soc. Nephrol. 16, 809–811 (2021).
pubmed: 33441465 pmcid: 8259475 doi: 10.2215/CJN.12710820
Hall, Y. N. Social determinants of health: addressing unmet needs in nephrology. Am. J. Kidney Dis. 72, 582–591 (2018).
pubmed: 29548780 doi: 10.1053/j.ajkd.2017.12.016
Crews, D. C. & Novick, T. K. Social determinants of CKD hotspots. Semin. Nephrol. 39, 256–262 (2019).
pubmed: 31054624 pmcid: 6508089 doi: 10.1016/j.semnephrol.2019.02.003
Brandt, E. J., Chang, T., Leung, C., Ayanian, J. Z. & Nallamothu, B. K. Food insecurity among individuals with cardiovascular disease and cardiometabolic risk factors across race and ethnicity in 1999-2018. JAMA Cardiol. 7, 1218–1226 (2012).
doi: 10.1001/jamacardio.2022.3729
Crews, D. C., Bello, A. K. & Saadi, G. 2019 World Kidney Day editorial — burden, access, and disparities in kidney disease. J. Bras. Nefrol. 41, 1–9 (2019).
pubmed: 31063178 pmcid: 6534018 doi: 10.1590/2175-8239-jbn-2018-0224
Tannor, E. K., Awaku, Y. A., Boima, V. & Antwi, S. The geographical distribution of dialysis services in Ghana. Ren. Repl. Ther. 4, 3 (2018).
doi: 10.1186/s41100-018-0143-1
Furia, F. F. et al. Developing nephrology services in low income countries: a case of Tanzania. BMC Nephrol. 20, 378 (2019).
pubmed: 31623570 pmcid: 6798480 doi: 10.1186/s12882-019-1568-7
Naicker, S., Eastwood, J. B., Plange-Rhule, J. & Tutt, R. C. Shortage of healthcare workers in sub-Saharan Africa: a nephrological perspective. Clin. Nephrol. 74, S129–S133 (2010).
pubmed: 20979978
van Zwieten, A., Wong, G. & Qader, M. A. Tackling health inequities for children and adolescents with CKD-A call to advocacy and action across the life course. Kidney Int. Rep. 7, 671–674 (2022).
pubmed: 35497808 pmcid: 9039902 doi: 10.1016/j.ekir.2022.02.008
Swartling, O. et al. Sex differences in the recognition, monitoring, and management of CKD in health care: an observational cohort study. J. Am. Soc. Nephrol. 33, 1903–1914 (2022).
pubmed: 35906075 pmcid: 9528319 doi: 10.1681/ASN.2022030373
Ravani, P. et al. Association of age with risk of kidney failure in adults with stage IV chronic kidney disease in Canada. JAMA Netw. Open. 3, e2017150 (2020).
pubmed: 32945876 pmcid: 7501537 doi: 10.1001/jamanetworkopen.2020.17150
O’Hare, A. M. How useful is an age-neutral model of chronic kidney disease? JAMA Netw. Open. 3, e2017592 (2020).
pubmed: 32945870 doi: 10.1001/jamanetworkopen.2020.17592
Scholes-Robertson, N. et al. Australian rural caregivers’ experiences in supporting patients with kidney failure to access dialysis and kidney transplantation: a qualitative study. Am. J. Kidney Dis. 80, 773–782.e1 (2022).
pubmed: 35868538 doi: 10.1053/j.ajkd.2022.05.015
Arici, M. Refugees with kidney disease: an increasing global challenge. Nat. Rev. Nephrol. 7, 366–367 (2021).
doi: 10.1038/s41581-020-00377-0
Van Biesen, W., Vanholder, R., Ernandez, T., Drewniak, D. & Luyckx, V. Caring for migrants and refugees with end-stage kidney disease in Europe. Am. J. Kidney Dis. 71, 701–709 (2018).
pubmed: 29274918 doi: 10.1053/j.ajkd.2017.10.015
Cervantes, L., Hasnain-Wynia, R., Steiner, J. F., Chonchol, M. & Fischer, S. Patient navigation: addressing social challenges in dialysis patients. Am. J. Kidney Dis. 76, 121–129 (2020).
pubmed: 31515136 doi: 10.1053/j.ajkd.2019.06.007
Sachs, J., Lafortune, G., Kroll, C., Fuller, G., Woelm, F. Sustainable Development Report 2022. From Crisis to Sustainable Development: the SDGs as Roadmap to 2030 and Beyond (Cambridge Univ. Press, 2022).
Morton, R. L. et al. Impact of educational attainment on health outcomes in moderate to severe CKD. Am. J. Kidney Dis. 67, 31–39 (2016).
pubmed: 26385817 pmcid: 4685934 doi: 10.1053/j.ajkd.2015.07.021
Arogundade, F. A. et al. Burden of end-stage renal disease in sub-Saharan Africa. Clin. Nephrol. 93, 3–7 (2020).
pubmed: 31397269 doi: 10.5414/CNP92S101
Kretchy, I. A. et al. Prevalence, patterns and beliefs about the use of herbal medicinal products in Ghana: a multi-centre community-based cross-sectional study. Trop. Med. Int. Health 26, 410–420 (2021).
pubmed: 33350035 doi: 10.1111/tmi.13541
Luyckx, V. A., Miljeteig, I., Ejigu, A. M. & Moosa, M. R. Ethical challenges in the provision of dialysis in resource-constrained environments. Semin. Nephrol. 37, 273–286 (2017).
pubmed: 28532556 doi: 10.1016/j.semnephrol.2017.02.007
Sever, M. S. et al. Armed conflicts and kidney patients: a consensus statement from the renal disaster relief task force of the ERA. Nephrol. Dial. Transpl. 38, 56–65 (2023).
doi: 10.1093/ndt/gfac247
Eneanya, N. D. et al. Health inequities and the inappropriate use of race in nephrology. Nat. Rev. Nephrol. 18, 84–94 (2022).
pubmed: 34750551 doi: 10.1038/s41581-021-00501-8
Hounkpatin, H. O. et al. Ethnic minority disparities in progression and mortality of pre-dialysis chronic kidney disease: a systematic scoping review. BMC Nephrol. 21, 217 (2020).
pubmed: 32517714 pmcid: 7282112 doi: 10.1186/s12882-020-01852-3
Epstein, A. M. et al. Racial disparities in access to renal transplantation — clinically appropriate or due to underuse or overuse? N. Engl. J. Med. 343, 1537–1544 (2000).
pubmed: 11087884 pmcid: 4598055 doi: 10.1056/NEJM200011233432106
Purnell, T. S. et al. Association of race and ethnicity with live donor kidney transplantation in the United States from 1995 to 2014. JAMA 319, 49–61 (2018).
pubmed: 29297077 pmcid: 5833543 doi: 10.1001/jama.2017.19152
Mehrotra, R. et al. Racial and ethnic disparities in use of and outcomes with home dialysis in the United States. J. Am. Soc. Nephrol. 27, 2123–2134 (2016).
pubmed: 26657565 doi: 10.1681/ASN.2015050472
Luyckx, V. A. & Brenner, B. M. Birth weight, malnutrition and kidney-associated outcomes-a global concern. Nat. Rev. Nephrol. 11, 135–149 (2015).
pubmed: 25599618 doi: 10.1038/nrneph.2014.251
LaVeist, T. A. et al. The economic burden of racial, ethnic, and educational health inequities in the US. JAMA 329, 1682–1692 (2023).
pubmed: 37191700 doi: 10.1001/jama.2023.5965
Purnell, T. S., Hall, Y. N. & Boulware, L. E. Understanding and overcoming barriers to living kidney donation among racial and ethnic minorities in the United States. Adv. Chronic Kidney Dis. 19, 244–251 (2012).
pubmed: 22732044 pmcid: 3385991 doi: 10.1053/j.ackd.2012.01.008
Obermeyer, Z., Powers, B., Vogeli, C. & Mullainathan, S. Dissecting racial bias in an algorithm used to manage the health of populations. Science 366, 447–453 (2019).
pubmed: 31649194 doi: 10.1126/science.aax2342
Gichoya, J. W. et al. AI recognition of patient race in medical imaging: a modelling study. Lancet Digit. Health 4, e406–e414 (2022).
pubmed: 35568690 pmcid: 9650160 doi: 10.1016/S2589-7500(22)00063-2
Williams, W. W., Hogan, J. W. & Ingelfinger, J. R. Time to eliminate health care disparities in the estimation of kidney function. N. Engl. J. Med. 385, 1804–1806 (2021).
pubmed: 34554659 doi: 10.1056/NEJMe2114918
Delanaye, P. et al. The « race » correction in estimating glomerular filtration rate: an European point of view. Curr. Opin. Nephrol. Hypertens. 30, 525–530 (2021).
pubmed: 34456237 doi: 10.1097/MNH.0000000000000739
Delgado, C. et al. A unifying approach for GFR estimation: recommendations of the NKF-ASN task force on reassessing the inclusion of race in diagnosing kidney disease. Am. J. Kidney Dis. 79, 268–88 e1 (2022).
pubmed: 34563581 doi: 10.1053/j.ajkd.2021.08.003
Weiss B. D. Health Literacy and Patient Safety: Help Patients Understand: Manual for Clinicians, 2nd edn (American Medical Association Foundation and American Medical Association, 2022).
Vellar, L., Mastroianni, F. & Lambert, K. Embedding health literacy into health systems: a case study of a regional health service. Aust. Health Rev. 41, 621–625 (2017).
pubmed: 27788351 doi: 10.1071/AH16109
Levy, H. & Janke, A. Health literacy and access to care. J. Health Commun. 21, Suppl. 1 43–50 (2016).
pubmed: 27043757 pmcid: 4924568 doi: 10.1080/10810730.2015.1131776
Blumenthal, S. J. & Kagen, J. MSJAMA. The effects of socioeconomic status on health in rural and urban America. JAMA 287, 109 (2002).
pubmed: 11754719 doi: 10.1001/jama.287.1.109-JMS0102-3-1
Scholes-Robertson, N. et al. Perspectives of a proposed patient navigator programme for people with chronic kidney disease in rural communities: report from national workshops. Nephrology 27, 886–896 (2022).
pubmed: 36056193 doi: 10.1111/nep.14105
Moist, L. M. et al. Travel time to dialysis as a predictor of health-related quality of life, adherence, and mortality: the dialysis outcomes and practice patterns study (DOPPS). Am. J. Kidney Dis. 51, 641–650 (2008).
pubmed: 18371540 doi: 10.1053/j.ajkd.2007.12.021
Evans, R., Rudd, P., Hemmila, U., Dobbie, H. & Dreyer, G. Deficiencies in education and experience in the management of acute kidney injury among Malawian healthcare workers. Malawi Med. J. 27, 101–103 (2015).
pubmed: 26715955 pmcid: 4688871 doi: 10.4314/mmj.v27i3.6
Baelani, I. et al. Identifying resource needs for sepsis care and guideline implementation in the Democratic Republic of the Congo: a cluster survey of 66 hospitals in four eastern provinces. Middle East. J. Anaesthesiol. 21, 559–575 (2012).
pubmed: 23327029
Olowu, W. A. et al. Outcomes of acute kidney injury in children and adults in sub-Saharan Africa: a systematic review. Lancet Glob. Health 4, e242–e250 (2016).
pubmed: 27013312 doi: 10.1016/S2214-109X(15)00322-8
Ramachandran, R. et al. Challenges in diagnosis and management of glomerular disease in resource-limited settings. Kidney Int. Rep. 7, 2141–2149 (2022).
pubmed: 36217525 pmcid: 9546742 doi: 10.1016/j.ekir.2022.07.002
Yeung, E. et al. Current status of health systems financing and oversight for end-stage kidney disease care: a cross-sectional global survey. BMJ Open 11, e047245 (2021).
pubmed: 34244267 pmcid: 8273453 doi: 10.1136/bmjopen-2020-047245
Ludlow, M. J., Lauder, L. A., Mathew, T. H., Hawley, C. M. & Fortnum, D. Australian consumer perspectives on dialysis: first national census. Nephrology 17, 703–709 (2012).
pubmed: 22882456 doi: 10.1111/j.1440-1797.2012.01651.x
Niang, A., Iyengar, A. & Luyckx, V. A. Hemodialysis versus peritoneal dialysis in resource-limited settings. Curr. Opin. Nephrol. Hypertens. 27, 463–471 (2018).
pubmed: 30148722 doi: 10.1097/MNH.0000000000000455
van der Tol, A., Lameire, N., Morton, R. L., Van Biesen, W. & Vanholder, R. An international analysis of dialysis services reimbursement. Clin. J. Am. Soc. Nephrol. 14, 84–93 (2019).
pubmed: 30545819 doi: 10.2215/CJN.08150718
Okpechi, I. G. et al. The case for increased peritoneal dialysis utilization in low- and lower-middle-income countries. Nephrology 27, 391–403 (2022).
pubmed: 35060223 doi: 10.1111/nep.14024
Brown, E. A. et al. Availability of assisted peritoneal dialysis in Europe: call for increased and equal access. Nephrol. Dial. Transpl. 37, 2080–2089 (2022).
doi: 10.1093/ndt/gfac193
Hamroun, A. et al. Barriers to conservative care from patients’ and nephrologists’ perspectives: the CKD-REIN Study. Nephrol. Dial. Transpl. 37, 2438–2448 (2022).
doi: 10.1093/ndt/gfac009
Wolfe, R. A. et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N. Engl. J. Med. 341, 1725–1730 (1999).
pubmed: 10580071 doi: 10.1056/NEJM199912023412303
Giwa, S. et al. The promise of organ and tissue preservation to transform medicine. Nat. Biotechnol. 35, 530–542 (2017).
pubmed: 28591112 pmcid: 5724041 doi: 10.1038/nbt.3889
Bello, A. K. et al. Global kidney health atlas (GKHA): design and methods. Kidney Int. Suppl. 7, 145–153 (2012).
doi: 10.1016/j.kisu.2017.08.001
Wu, D. A. et al. Global trends and challenges in deceased donor kidney allocation. Kidney Int. 91, 1287–1299 (2017).
pubmed: 28320531 doi: 10.1016/j.kint.2016.09.054
Vanholder, R. et al. Organ donation and transplantation: a multi-stakeholder call to action. Nat. Rev. Nephrol. 17, 554–568 (2021).
pubmed: 33953367 pmcid: 8097678 doi: 10.1038/s41581-021-00425-3
Tiong, M. K., Thomas, S., Fernandes, D. K. & Cherian, S. Examining barriers to timely waitlisting for kidney transplantation for Indigenous Australians in central Australia. Intern. Med. J. 52, 288–294 (2022).
pubmed: 33251718 doi: 10.1111/imj.14960
Rota-Musoll, L. et al. An intersectional gender analysis in kidney transplantation: women who donate a kidney. BMC Nephrol. 22, 59 (2021).
pubmed: 33593306 pmcid: 7885450 doi: 10.1186/s12882-021-02262-9
Hecking, M. et al. Sex-specific differences in mortality and incident dialysis in the chronic kidney disease outcomes and practice patterns study. Kidney Int. Rep. 7, 410–423 (2022).
pubmed: 35257054 doi: 10.1016/j.ekir.2021.11.018
Sever, M. S. et al. Ethical and medical dilemmas in paid living kidney donor transplantation. Transpl. Rev. 36, 100726 (2022).
doi: 10.1016/j.trre.2022.100726
Steering Committee of the Istanbul S. Organ trafficking and transplant tourism and commercialism: the declaration of Istanbul. Lancet 372, 5–6 (2008).
doi: 10.1016/S0140-6736(08)60967-8
Banerjee, S., Kamath, N., Antwi, S. & Bonilla-Felix, M. Paediatric nephrology in under-resourced areas. Pediatr. Nephrol. 37, 959–972 (2022).
pubmed: 33839937 doi: 10.1007/s00467-021-05059-y
Macedo, E. et al. Recognition and management of acute kidney injury in children: the ISN 0by25 Global Snapshot study. PLoS ONE 13, e0196586 (2018).
pubmed: 29715307 pmcid: 5929512 doi: 10.1371/journal.pone.0196586
Kennedy, S. E., Bailey, R. & Kainer, G. Causes and outcome of late referral of children who develop end-stage kidney disease. J. Paediatr. Child. Health 48, 253–258 (2012).
pubmed: 22118552 doi: 10.1111/j.1440-1754.2011.02254.x
Chesnaye, N. C. et al. Mortality risk in European children with end-stage renal disease on dialysis. Kidney Int. 89, 1355–1362 (2016).
pubmed: 27165828 doi: 10.1016/j.kint.2016.02.016
Pais, P., Blydt-Hansen, T. D., Michael Raj, J. A., Dello Strologo, L. & Iyengar, A. Low renal transplantation rates in children with end-stage kidney disease: a study of barriers in a low-resource setting. Pediatr. Transpl. 25, e13867 (2021).
doi: 10.1111/petr.13867
Sarnak, D. O., Squires, D., Kuzmak, G. & Bishop, S. Paying for prescription drugs around the world: why is the U.S. an outlier? Issue Brief. 2017, 1–14 (2017).
pubmed: 28990747
Vanholder, R., Van Biesen, W. & Lameire, N. Renal replacement therapy: how can we contain the costs? Lancet 383, 1783–1785 (2014).
pubmed: 24856012 doi: 10.1016/S0140-6736(14)60721-2
Mohnen, S. M. et al. Healthcare costs of patients on different renal replacement modalities — analysis of Dutch health insurance claims data. PLoS ONE 14, e0220800 (2019).
pubmed: 31415578 pmcid: 6695145 doi: 10.1371/journal.pone.0220800
de Vries, E. F., Los, J., de Wit, G. A. & Hakkaart-van, R. L. Patient, family and productivity costs of end-stage renal disease in the Netherlands; exposing non-healthcare related costs. BMC Nephrol. 22, 341 (2021).
pubmed: 34656083 pmcid: 8520215 doi: 10.1186/s12882-021-02548-y
Essue, B. M. et al. in Disease Control Priorities Improving Health and Reducing Poverty 3 edn (eds Jamison, D. T., Gelband H., Horton S. et al.) 121–143 (World Bank, 2018).
Luyckx, V. A. & Moosa, M. R. Priority setting as an ethical imperative in managing global dialysis access and improving kidney care. Semin. Nephrol. 41, 230–241 (2021).
pubmed: 34330363 doi: 10.1016/j.semnephrol.2021.05.004
Sculpher M., Revill P., Ochalek J. M., Claxton K. in What’s In, What’s Out? Designing Benefits for Universal Health Coverage (eds Glassman, A. et al.) 115–140 (Center for Global Development, USA).
Howell, M., Walker, R. C. & Howard, K. Cost effectiveness of dialysis modalities: a systematic review of economic evaluations. Appl. Health Econ. Health Policy 17, 315–330 (2019).
pubmed: 30714086 doi: 10.1007/s40258-018-00455-2
Johri, M. & Norheim, O. F. Can cost-effectiveness analysis integrate concerns for equity? Systematic review. Int. J. Technol. Assess. Health Care 28, 125–132 (2012).
pubmed: 22494637 doi: 10.1017/S0266462312000050
Himmelfarb, J., Vanholder, R., Mehrotra, R. & Tonelli, M. The current and future landscape of dialysis. Nat. Rev. Nephrol. 16, 573–585 (2020).
pubmed: 32733095 pmcid: 7391926 doi: 10.1038/s41581-020-0315-4
van der Tol, A. et al. A call for harmonization of European kidney care: dialysis reimbursement and distribution of kidney replacement therapies. Nephrol. Dial. Transpl. 35, 979–986 (2020).
doi: 10.1093/ndt/gfaa035
Van Biesen, W. et al. Considerations on equity in management of end-stage kidney disease in low- and middle-income countries. Kidney Int. Suppl. 10, e63–e71 (2020).
doi: 10.1016/j.kisu.2019.11.004
Ashu, J. T. et al. Challenges to the right to health in sub-Saharan Africa: reflections on inequities in access to dialysis for patients with end-stage kidney failure. Int. J. Equity Health 21, 126 (2022).
pubmed: 36064532 pmcid: 9444088 doi: 10.1186/s12939-022-01715-3
Crosby, L. et al. Dialysis in Africa: the need for evidence-informed decision making. Lancet Glob. Health 8, e476–e477 (2020).
pubmed: 32199114 pmcid: 7613493 doi: 10.1016/S2214-109X(20)30058-9
Luyckx, V. A. et al. Sustainable Development Goals relevant to kidney health: an update on progress. Nat. Rev. Nephrol. 17, 15–32 (2021).
pubmed: 33188362 doi: 10.1038/s41581-020-00363-6
Sumaili, E. K. et al. High prevalence of undiagnosed chronic kidney disease among at-risk population in Kinshasa, the Democratic Republic of Congo. BMC Nephrol. 10, 18 (2009).
pubmed: 19622160 pmcid: 2724413 doi: 10.1186/1471-2369-10-18
World Health Organization. Saving Lives, Spending Less: The Case for Investing In Noncommunicable Diseases. https://www.who.int/publications/i/item/9789240041059 (2021).
Ameh, O. I., Ekrikpo, U. E. & Kengne, A. P. Preventing CKD in low- and middle-income countries: a call for urgent action. Kidney Int. Rep. 5, 255–262 (2020).
pubmed: 32154447 doi: 10.1016/j.ekir.2019.12.013
Karpman, D. & Hoglund, P. Orphan drug policies and use in pediatric nephrology. Pediatr. Nephrol. 32, 1–6 (2017).
pubmed: 27738765 doi: 10.1007/s00467-016-3520-4
Zimmermann, B. M., Eichinger, J. & Baumgartner, M. R. A systematic review of moral reasons on orphan drug reimbursement. Orphanet J. Rare Dis. 16, 292 (2021).
pubmed: 34193232 pmcid: 8247078 doi: 10.1186/s13023-021-01925-y
Berdud, M., Drummond, M. & Towse, A. Establishing a reasonable price for an orphan drug. Cost. Eff. Resour. Alloc. 18, 31 (2020).
pubmed: 32908456 pmcid: 7472708 doi: 10.1186/s12962-020-00223-x
Onakpoya, I. J., Spencer, E. A., Thompson, M. J. & Heneghan, C. J. Effectiveness, safety and costs of orphan drugs: an evidence-based review. BMJ Open. 5, e007199 (2015).
pubmed: 26109112 pmcid: 4480037 doi: 10.1136/bmjopen-2014-007199
Kesselheim, A. S. et al. The prevalence and cost of unapproved uses of top-selling orphan drugs. PLoS ONE 7, e31894 (2012).
pubmed: 22363762 pmcid: 3283698 doi: 10.1371/journal.pone.0031894
Young, K. E., Soussi, I. & Toumi, M. The perverse impact of external reference pricing (ERP): a comparison of orphan drugs affordability in 12 European countries. A call for policy change. J. Mark. Access. Health Policy 5, 1369817 (2017).
pubmed: 29081920 pmcid: 5645904 doi: 10.1080/20016689.2017.1369817
Gammie, T., Lu, C. Y. & Babar, Z. U. Access to orphan drugs: a comprehensive review of legislations, regulations and policies in 35 countries. PLoS ONE 10, e0140002 (2015).
pubmed: 26451948 pmcid: 4599885 doi: 10.1371/journal.pone.0140002
Marmot, M. Just societies, health equity, and dignified lives: the PAHO equity commission. Lancet 392, 2247–2250 (2018).
pubmed: 30262335 doi: 10.1016/S0140-6736(18)32349-3
Garcia, G. G. et al. Sex and gender differences in chronic kidney disease and access to care around the globe. Semin. Nephrol. 42, 101–113 (2022).
pubmed: 35718358 doi: 10.1016/j.semnephrol.2022.04.001
Moosa, M. R. & Luyckx, V. A. The realities of rationing in health care. Nat. Rev. Nephrol. 17, 435–436 (2021).
pubmed: 33589744 pmcid: 7883325 doi: 10.1038/s41581-021-00404-8
Venkatapuram, S. Health Justice: An Argument from the Capabilities Approach (Polity Press, 2011).
Uberoi, D. & Forman, L. What role can the right to health play in advancing equity in kidney care? Semin. Nephrol. 41, 220–229 (2021).
pubmed: 34330362 doi: 10.1016/j.semnephrol.2021.05.003
Braveman, P. A. et al. Health disparities and health equity: the issue is justice. Am. J. Public. Health 101, Suppl. 1 S149–S155 (2011).
pubmed: 21551385 pmcid: 3222512 doi: 10.2105/AJPH.2010.300062
World Health Organization. Noncommunicable diseases. https://www.who.int/teams/surveillance-of-noncommunicable-diseases/about/ncds (accessed 31 July 2023).
Chin, M. H. et al. A roadmap and best practices for organizations to reduce racial and ethnic disparities in health care. J. Gen. Intern. Med. 27, 992–1000 (2012).
pubmed: 22798211 pmcid: 3403142 doi: 10.1007/s11606-012-2082-9
European Commission. Public Health. European Reference Networks. https://health.ec.europa.eu/european-reference-networks/overview_en (2023).
Plahte, J. Tiered pricing of vaccines: a win-win-win situation, not a subsidy. Lancet Infect. Dis. 5, 58–63 (2005).
pubmed: 15620562 doi: 10.1016/S1473-3099(04)01255-1
Gopichandran, V. et al. Developing the ethics of implementation research in health. Implement. Sci. 11, 161 (2016).
pubmed: 27938400 pmcid: 5148832 doi: 10.1186/s13012-016-0527-y
Jager, K. J. et al. A snapshot of European registries on chronic kidney disease patients not on kidney replacement therapy. Nephrol. Dial. Transpl. 37, 8–13 (2021).
doi: 10.1093/ndt/gfab252
Qaseem, A., Hopkins, R. H. Jr., Sweet, D. E., Starkey, M. & Shekelle, P. Screening, monitoring, and treatment of stage 1 to 3 chronic kidney disease: a clinical practice guideline from the American College of Physicians. Ann. Intern. Med. 159, 835–847 (2013).
pubmed: 24145991 doi: 10.7326/0003-4819-159-11-201312030-00009
Greer, R. & Boulware, L. E. Reducing CKD risks among vulnerable populations in primary care. Adv. Chronic Kidney Dis. 22, 74–80 (2015).
pubmed: 25573516 pmcid: 4291538 doi: 10.1053/j.ackd.2014.06.003
Hull, S., Dreyer, G., Badrick, E., Chesser, A. & Yaqoob, M. M. The relationship of ethnicity to the prevalence and management of hypertension and associated chronic kidney disease. BMC Nephrol. 12, 41 (2011).
pubmed: 21896189 pmcid: 3180366 doi: 10.1186/1471-2369-12-41
Tenkorang, E. Y. & Kuuire, V. Z. Noncommunicable diseases in Ghana: does the theory of social gradient in health hold? Health Educ. Behav. 43, 25S–36S (2016).
pubmed: 27037145 doi: 10.1177/1090198115602675
Wardle, J. & Steptoe, A. Socioeconomic differences in attitudes and beliefs about healthy lifestyles. J. Epidemiol. Community Health 57, 440–443 (2003).
pubmed: 12775791 pmcid: 1732468 doi: 10.1136/jech.57.6.440
United Nations. Department of Economic and Social Affairs. Sustainable Development Goal 3, https://sdgs.un.org/goals/goal3 (2022).
Chapman, A. R. Assessing the universal health coverage target in the sustainable development goals from a human rights perspective. BMC Int. Health Hum. Rights 16, 33 (2016).
pubmed: 27978827 pmcid: 5159947 doi: 10.1186/s12914-016-0106-y
Annemans, L. A proposal for value informed, affordable (“via”) prices for innovative medicines. J. Med. Econ. 22, 1235–1239 (2019).
pubmed: 31199174 doi: 10.1080/13696998.2019.1632203
Cookson, R. et al. Using cost-effectiveness analysis to address health equity concerns. Value Health 20, 206–212 (2017).
pubmed: 28237196 pmcid: 5340318 doi: 10.1016/j.jval.2016.11.027
Bukhman, G. et al. From a Lancet commission to the NCDI poverty network: reaching the poorest billion through integration science. Lancet 398, 2217–2220 (2021).
pubmed: 34687660 doi: 10.1016/S0140-6736(21)02321-7
Piaggio, D. et al. A framework for designing medical devices resilient to low-resource settings. Glob. Health 17, 64 (2021).
doi: 10.1186/s12992-021-00718-z
Karopadi, A. N., Mason, G., Rettore, E. & Ronco, C. Cost of peritoneal dialysis and haemodialysis across the world. Nephrol. Dial. Transpl. 28, 2553–2569 (2013).
doi: 10.1093/ndt/gft214
Mendu, M. L. et al. Expanding utilization of home dialysis: an action agenda from the first international home dialysis roundtable. Kidney Med. 3, 635–643 (2021).
pubmed: 34401729 pmcid: 8350829 doi: 10.1016/j.xkme.2021.04.004
Good Medical Council. Good Medical Practice, https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/good-medical-practice (2019).
Vanholder, R., Conway, P. T., Gallego, D., Scheres, E. & Wieringa, F. The European Kidney Health Alliance (EKHA) and the Decade of the Kidney™. Nephrol. Dial. Transpl. 38, 1113–1122 (2023).
doi: 10.1093/ndt/gfac211
EUPATI. https://eupati.eu (2023).
Abdel-Kader, K., Greer, R. C., Boulware, L. E. & Unruh, M. L. Primary care physicians’ familiarity, beliefs, and perceived barriers to practice guidelines in non-diabetic CKD: a survey study. BMC Nephrol. 15, 64 (2014).
pubmed: 24755164 pmcid: 4021215 doi: 10.1186/1471-2369-15-64
Lusignan, S. et al. Audit-based education lowers systolic blood pressure in chronic kidney disease: the Quality Improvement in CKD (QICKD) trial results. Kidney Int. 84, 609–620 (2013).
pubmed: 23536132 doi: 10.1038/ki.2013.96
Bashshur, R. L. On the definition and evaluation of telemedicine. Telemed. J. 1, 19–30 (1995).
pubmed: 10165319 doi: 10.1089/tmj.1.1995.1.19
Parker, J. C. Cherry picking in ESRD: an ethical challenge in the era of pay for performance. Semin. Dialysis 24, 5–8 (2011).
doi: 10.1111/j.1525-139X.2010.00806.x
Singer, P., McKie, J., Kuhse, H. & Richardson, J. Double jeopardy and the use of QALYs in health care allocation. J. Med. Ethics 21, 144–150 (1995).
pubmed: 7674278 pmcid: 1376689 doi: 10.1136/jme.21.3.144
Amaral, S. et al. Association between dialysis facility ownership and access to the waiting list and transplant in pediatric patients with end-stage kidney disease in the US. JAMA 328, 451–459 (2022).
pubmed: 35916847 pmcid: 9346544 doi: 10.1001/jama.2022.11231
Calderon, J. L. et al. Improving diabetes health literacy by animation. Diabetes Educ. 40, 361–372 (2014). 2014.
pubmed: 24676274 pmcid: 6309339 doi: 10.1177/0145721714527518
Koh, H. K., Brach, C., Harris, L. M. & Parchman, M. L. A proposed ‘health literate care model’ would constitute a systems approach to improving patients’ engagement in care. Health Aff. 32, 357–367 (2013).
doi: 10.1377/hlthaff.2012.1205
Jukkala, A., Deupree, J. P. & Graham, S. Knowledge of limited health literacy at an academic health center. J. Contin. Educ. Nurs. 40, 298–302 (2009). quiz 3-4, 36.
pubmed: 19639850 doi: 10.3928/00220124-20090623-01
Karuranga, S., Sorensen, K., Coleman, C. & Mahmud, A. J. Health literacy competencies for European health care personnel. Health Lit. Res. Pract. 1, e247–e256 (2017).
pubmed: 31294270 pmcid: 6607779
Elwyn, G. et al. Shared decision making: a model for clinical practice. J. Gen. Intern. Med. 27, 1361–1367 (2012).
pubmed: 22618581 pmcid: 3445676 doi: 10.1007/s11606-012-2077-6
Murgic, L., Hebert, P. C., Sovic, S. & Pavlekovic, G. Paternalism and autonomy: views of patients and providers in a transitional (post-communist) country. BMC Med. Ethics 16, 65 (2015).
pubmed: 26420014 pmcid: 4589086 doi: 10.1186/s12910-015-0059-z
Joosten, E. A. et al. Systematic review of the effects of shared decision-making on patient satisfaction, treatment adherence and health status. Psychother. Psychosom. 77, 219–226 (2008).
pubmed: 18418028 doi: 10.1159/000126073
Rosner, M. H., Husain-Syed, F., Reis, T., Ronco, C. & Vanholder, R. Uremic encephalopathy. Kidney Int. 101, 227–241 (2022).
pubmed: 34736971 doi: 10.1016/j.kint.2021.09.025

Auteurs

Raymond Vanholder (R)

European Kidney Health Alliance, Brussels, Belgium. Raymond.vanholder@ugent.be.
Nephrology Section, Department of Internal Medicine and Paediatrics, University Hospital Ghent, Ghent, Belgium. Raymond.vanholder@ugent.be.

Lieven Annemans (L)

Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.

Marion Braks (M)

European Kidney Health Alliance, Brussels, Belgium.
Association Renaloo, Paris, France.

Edwina A Brown (EA)

Imperial College Healthcare NHS Trust, Imperial College Renal and Transplant Center, London, UK.

Priya Pais (P)

Department of Paediatric Nephrology, St John's Medical College, Bengaluru, India.

Tanjala S Purnell (TS)

Departments of Epidemiology and Surgery, Johns Hopkins University, Baltimore, MD, USA.

Simon Sawhney (S)

Aberdeen Centre for Health Data Science, University of Aberdeen, Aberdeen, UK.

Nicole Scholes-Robertson (N)

Rural and Remote Health, Flinders University, Adelaide, South Australia, Australia.

Bénédicte Stengel (B)

Clinical Epidemiology Team, Center for Research in Epidemiology and Population Health (CESP), University Paris-Saclay, UVSQ, Inserm, Villejuif, France.

Elliot K Tannor (EK)

Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Renal Unit, Directorate of Medicine, Komfo Anokye, Teaching Hospital, Kumasi, Ghana.

Vladimir Tesar (V)

Department of Nephrology, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic.

Arjan van der Tol (A)

Nephrology Section, Department of Internal Medicine and Paediatrics, University Hospital Ghent, Ghent, Belgium.

Valérie A Luyckx (VA)

Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.
Department of Public and Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland.

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