Global access of patients with kidney disease to health technologies and medications: findings from the Global Kidney Health Atlas project

Htay Htay, Mona Alrukhaimi, Gloria E. Ashuntantang, Aminu K. Bello, Ezequiel Bellorin-Font, Mohammed Benghanem Gharbi, Branko Braam, John Feehally, David C. Harris, Vivekanand Jha, Kailash Jindal, Kamyar Kalantar-Zadeh, Rumeyza Kazancioglu, Peter G. Kerr, Adeera Levin, Meaghan Lunney, Ikechi G. Okpechi, Michelle E. Olah, Timothy Olusegun Olanrewaju, Mohamed A. OsmanYasin Parpia, Jeffrey Perl, Bilal Qarni, Harun Ur Rashid, Ahmed Rateb, Eric Rondeau, Babatunde Lawal Salako, Laura Sola, Irma Tchokhonelidze, Marcello Tonelli, Natasha Wiebe, Isaac Wirzba, Chih Wei Yang, Feng Ye, Alexander Zemchenkov, Ming hui Zhao, David W. Johnson

Research output: Contribution to journalReview ArticleResearchpeer-review

80 Citations (Scopus)


Access to essential medications and health products is critical to effective management of kidney disease. Using data from the ISN Global Kidney Health Atlas multinational cross-sectional survey, global access of patients with kidney disease to essential medications and health products was examined. Overall, 125 countries participated, with 118 countries, composing 91.5% of the world's population, providing data on this domain. Most countries were unable to access eGFR and albuminuria in their primary care settings. Only one-third of low-income countries (LICs) were able to measure serum creatinine and none were able to access eGFR or quantify proteinuria. The ability to monitor diabetes mellitus through serum glucose and glycated hemoglobin measurements was suboptimal. Pathology services were rarely available in tertiary care in LICs (12%) and lower middle-income countries (45%). While acute and chronic hemodialysis services were available in almost all countries, acute and chronic peritoneal dialysis services were rarely available in LICs (18% and 29%, respectively). Kidney transplantation was available in 79% of countries overall and in 12% of LICs. While over one-half of all countries publicly funded RRT and kidney medications with or without copayment, this was less common in LICs and lower middle-income countries. In conclusion, this study demonstrated significant gaps in services for kidney care and funding that were most apparent in LICs and lower middle-income countries.

Original languageEnglish
Pages (from-to)64-73
Number of pages10
JournalKidney International Supplements
Issue number2
Publication statusPublished - Feb 2018


  • acute kidney injury and chronic kidney disease care
  • funding for health care
  • funding for medications
  • global health care
  • health care service provision
  • renal replacement therapy

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