@article{21526, keywords = {Adult, Humans, Aged, Middle Aged, Adolescent, Child, Preschool, Prevalence, Aged, 80 and over, Child, Young Adult, Infant, Infant, Newborn, Global Health, Health Services Accessibility/standards/ statistics & numerical data, Kidney Failure, Chronic/epidemiology/ therapy, Renal Replacement Therapy/ utilization}, author = {Liyanage T. and Garg A. and Lv J. and Ninomiya T. and Cass A. and Gallagher M. and Knight J. and Jha V. and Patrice H. and Okpechi I. and Zhao M. and Rodgers A and Perkovic Vlado and Kotwal Sradha and Neal Bruce}, title = {Worldwide access to treatment for end-stage kidney disease: a systematic review}, abstract = {

BACKGROUND: End-stage kidney disease is a leading cause of morbidity and mortality worldwide. Prevalence of the disease and worldwide use of renal replacement therapy (RRT) are expected to rise sharply in the next decade. We aimed to quantify estimates of this burden. METHODS: We systematically searched Medline for observational studies and renal registries, and contacted national experts to obtain RRT prevalence data. We used Poisson regression to estimate the prevalence of RRT for countries without reported data. We estimated the gap between needed and actual RRT, and projected needs to 2030. FINDINGS: In 2010, 2.618 million people received RRT worldwide. We estimated the number of patients needing RRT to be between 4.902 million (95% CI 4.438-5.431 million) in our conservative model and 9.701 million (8.544-11.021 million) in our high-estimate model, suggesting that at least 2.284 million people might have died prematurely because RRT could not be accessed. We noted the largest treatment gaps in low-income countries, particularly Asia (1.907 million people needing but not receiving RRT; conservative model) and Africa (432,000 people; conservative model). Worldwide use of RRT is projected to more than double to 5.439 million (3.899-7.640 million) people by 2030, with the most growth in Asia (0.968 million to a projected 2.162 million [1.571-3.014 million]). INTERPRETATION: The large number of people receiving RRT and the substantial number without access to it show the need to both develop low-cost treatments and implement effective population-based prevention strategies. FUNDING: Australian National Health and Medical Research Council.

}, year = {2015}, journal = {Lancet}, volume = {385}, edition = {2015/03/18}, number = {9981}, pages = {1975-82}, month = {-45603718451}, isbn = {1474-547X (Electronic)
0140-6736 (Linking)}, note = {Liyanage, Thaminda
Ninomiya, Toshiharu
Jha, Vivekanand
Neal, Bruce
Patrice, Halle Marie
Okpechi, Ikechi
Zhao, Ming-hui
Lv, Jicheng
Garg, Amit X
Knight, John
Rodgers, Anthony
Gallagher, Martin
Kotwal, Sradha
Cass, Alan
Perkovic, Vlado
Research Support, Non-U.S. Gov't
Review
England
Lancet. 2015 May 16;385(9981):1975-82. doi: 10.1016/S0140-6736(14)61601-9. Epub 2015 Mar 13.}, language = {eng}, }