Meaghan Lunney1, Aminu K Bello2, Adeera Levin3, Helen Tam-Tham4, Chandra Thomas4, Mohamed A Osman5, Feng Ye2, Ezequiel Bellorin-Font6, Mohammed Benghanem Gharbi7, Mohammad Ghnaimat8, Htay Htay9, Yeoungjee Cho10,11,12, Vivekanand Jha13,14,15, Shahrzad Ossareh16, Eric Rondeau17,18, Laura Sola19, Irma Tchokhonelidze20, Vladimir Tesar21, Kriang Tungsanga22,23, Rumeyza Turan Kazancioglu24, Angela Yee-Moon Wang25, Chih-Wei Yang26,27, Alexander Zemchenkov28,29, Ming-Hui Zhao30,31,32,33, Kitty J Jager34, Kailash K Jindal2, Ikechi G Okpechi35,36, Edwina A Brown37, Mark Brown38, Marcello Tonelli4,39, David C Harris40, David W Johnson41,11,12, Fergus J Caskey42,43, Sara N Davison44. 1. Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. 2. Division of Nephrology and Immunology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. 3. Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. 4. Department of Medicine, University of Calgary, Calgary, Alberta, Canada. 5. Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada. 6. Division of Nephology and Hypertension, Saint Louis University, St. Louis, Missouri. 7. Urinary Tract Diseases Department, Faculty of Medicine and Pharmacy of Casablanca, University Hassan II of Casablanca, Casablanca, Morocco. 8. Nephrology Division, Department of Internal Medicine, The Specialty Hospital, Amman, Jordan. 9. Department of Renal Medicine, Singapore General Hospital, Singapore. 10. Australasian Kidney Trials Network, University of Queensland, Brisbane, Queensland, Australia sara.davison@ualberta.ca. 11. Translational Research Institute, Brisbane, Queensland, Australia. 12. Metro South Integrated Nephrology and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia. 13. George Institute for Global Health, University of New South Wales, New Delhi, India. 14. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom. 15. Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India. 16. Division of Nephrology, Department of Medicine, Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran. 17. Intensive Care Nephrology and Transplantation Department, Hopital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France. 18. Intensive Care Nephrology and Transplantation Department, Hopital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France and Sorbonne Université, Paris, France. 19. Dialysis Unit, Centro de Asistencia del Sindicato Médico del Uruguay - Institución de Asistencia Medica Privada de Profesionales (CASMU-IAMPP), Montevideo, Uruguay. 20. Nephrology Development Clinical Center, Tbilisi State Medical University, Tbilisi, Georgia. 21. Department of Nephrology, General University Hospital, Charles University, Prague, Czech Republic. 22. Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand. 23. Division of Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Bhumirajanagarindra Kidney Institute, Bangkok, Thailand. 24. Division of Nephrology, Bezmialem Vakif University, Istanbul, Turkey. 25. Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region, China. 26. Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan. 27. Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan. 28. Department of Internal Diseases, Clinical Pharmacology, and Nephrology, North-Western State Medical University named after I. I. Mechnikov, St. Petersburg, Russia. 29. Department of Nephrology and Dialysis, Pavlov First St. Petersburg State Medical University, St. Petersburg, Russia. 30. Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China. 31. Key Lab of Renal Disease, Ministry of Health of China, Beijing, China. 32. Key Lab of Chronic Kidney Disease Prevention and Treatment, Ministry of Education of China, Beijing, China. 33. Peking-Tsinghua Center for Life Sciences, Beijing, China. 34. European Renal Association - European Dialysis and Transplant Association (ERA-EDTA) Registry, Department of Medical Informatics, Academic Medical Center, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands. 35. Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa. 36. Kidney and Hypertension Research Unit, University of Cape Town, Cape Town, South Africa. 37. Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, England. 38. Department of Renal Medicine, St George Hospital and University of New South Wales, Sydney, New South Wales, Australia. 39. Pan-American Health Organization/World Health Organization's Collaborating Centre in Prevention and Control of Chronic Kidney Disease, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. 40. Centre for Transplantation and Renal Research, Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia. 41. Australasian Kidney Trials Network, University of Queensland, Brisbane, Queensland, Australia. 42. UK Renal Registry, Learning and Research, Southmead Hospital, Bristol, United Kingdom and Population Health Sciences, University of Bristol, Bristol, United Kingdom. 43. Richard Bright Renal Unit, Southmead Hospital, North Bristol National Health Service Trust, Bristol, United Kingdom. 44. Division of Nephrology and Immunology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada sara.davison@ualberta.ca.
Abstract
BACKGROUND AND OBJECTIVES: People with kidney failure typically receive KRT in the form of dialysis or transplantation. However, studies have suggested that not all patients with kidney failure are best suited for KRT. Additionally, KRT is costly and not always accessible in resource-restricted settings. Conservative kidney management is an alternate kidney failure therapy that focuses on symptom management, psychologic health, spiritual care, and family and social support. Despite the importance of conservative kidney management in kidney failure care, several barriers exist that affect its uptake and quality. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The Global Kidney Health Atlas is an ongoing initiative of the International Society of Nephrology that aims to monitor and evaluate the status of global kidney care worldwide. This study reports on findings from the 2018 Global Kidney Health Atlas survey, specifically addressing the availability, accessibility, and quality of conservative kidney management. RESULTS: Respondents from 160 countries completed the survey, and 154 answered questions pertaining to conservative kidney management. Of these, 124 (81%) stated that conservative kidney management was available. Accessibility was low worldwide, particularly in low-income countries. Less than half of countries utilized multidisciplinary teams (46%); utilized shared decision making (32%); or provided psychologic, cultural, or spiritual support (36%). One-quarter provided relevant health care providers with training on conservative kidney management delivery. CONCLUSIONS: Overall, conservative kidney management is available in most countries; however, it is not optimally accessible or of the highest quality.
BACKGROUND AND OBJECTIVES: People with kidney failure typically receive KRT in the form of dialysis or transplantation. However, studies have suggested that not all patients with kidney failure are best suited for KRT. Additionally, KRT is costly and not always accessible in resource-restricted settings. Conservative kidney management is an alternate kidney failure therapy that focuses on symptom management, psychologic health, spiritual care, and family and social support. Despite the importance of conservative kidney management in kidney failure care, several barriers exist that affect its uptake and quality. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The Global Kidney Health Atlas is an ongoing initiative of the International Society of Nephrology that aims to monitor and evaluate the status of global kidney care worldwide. This study reports on findings from the 2018 Global Kidney Health Atlas survey, specifically addressing the availability, accessibility, and quality of conservative kidney management. RESULTS: Respondents from 160 countries completed the survey, and 154 answered questions pertaining to conservative kidney management. Of these, 124 (81%) stated that conservative kidney management was available. Accessibility was low worldwide, particularly in low-income countries. Less than half of countries utilized multidisciplinary teams (46%); utilized shared decision making (32%); or provided psychologic, cultural, or spiritual support (36%). One-quarter provided relevant health care providers with training on conservative kidney management delivery. CONCLUSIONS: Overall, conservative kidney management is available in most countries; however, it is not optimally accessible or of the highest quality.
Authors: Mark A Brown; Susan M Crail; Rosemary Masterson; Celine Foote; Jennifer Robins; Ivor Katz; Elizabeth Josland; Frank Brennan; Elizabeth J Stallworthy; Brian Siva; Cathy Miller; A Katalin Urban; Cherian Sajiv; R Naida Glavish; Steven May; Robyn Langham; Robert Walker; Robert G Fassett; Rachael L Morton; Cameron Stewart; Lisa Phipps; Helen Healy; Ilse Berquier Journal: Nephrology (Carlton) Date: 2013-06 Impact factor: 2.506
Authors: Aminu K Bello; David W Johnson; John Feehally; David Harris; Kailash Jindal; Meaghan Lunney; Ikechi G Okpechi; Babatunde L Salako; Natasha Wiebe; Feng Ye; Marcello Tonelli; Adeera Levin Journal: Kidney Int Suppl (2011) Date: 2017-09-20
Authors: Sara N Davison; Adeera Levin; Alvin H Moss; Vivekanand Jha; Edwina A Brown; Frank Brennan; Fliss E M Murtagh; Saraladevi Naicker; Michael J Germain; Donal J O'Donoghue; Rachael L Morton; Gregorio T Obrador Journal: Kidney Int Date: 2015-04-29 Impact factor: 10.612
Authors: Aminu K Bello; Adeera Levin; Marcello Tonelli; Ikechi G Okpechi; John Feehally; David Harris; Kailash Jindal; Babatunde L Salako; Ahmed Rateb; Mohamed A Osman; Bilal Qarni; Syed Saad; Meaghan Lunney; Natasha Wiebe; Feng Ye; David W Johnson Journal: JAMA Date: 2017-05-09 Impact factor: 56.272
Authors: David C H Harris; Simon J Davies; Fredric O Finkelstein; Vivekanand Jha; Jo-Ann Donner; Georgi Abraham; Aminu K Bello; Fergus J Caskey; Guillermo Garcia Garcia; Paul Harden; Brenda Hemmelgarn; David W Johnson; Nathan W Levin; Valerie A Luyckx; Dominique E Martin; Mignon I McCulloch; Mohammed Rafique Moosa; Philip J O'Connell; Ikechi G Okpechi; Roberto Pecoits Filho; Kamal D Shah; Laura Sola; Charles Swanepoel; Marcello Tonelli; Ahmed Twahir; Wim van Biesen; Cherian Varghese; Chih-Wei Yang; Carlos Zuniga Journal: Kidney Int Date: 2019-04 Impact factor: 10.612
Authors: Vanessa Grubbs; Delphine S Tuot; Neil R Powe; Donal O'Donoghue; Catherine A Chesla Journal: Am J Kidney Dis Date: 2017-02-24 Impact factor: 8.860
Authors: Barnaby Hole; Brenda Hemmelgarn; Edwina Brown; Mark Brown; Mignon I McCulloch; Carlos Zuniga; Sharon P Andreoli; Peter G Blake; Cécile Couchoud; Alfonso M Cueto-Manzano; Gavin Dreyer; Guillermo Garcia Garcia; Kitty J Jager; Marla McKnight; Rachael L Morton; Fliss E M Murtagh; Saraladevi Naicker; Gregorio T Obrador; Jeffrey Perl; Muhibur Rahman; Kamal D Shah; Wim Van Biesen; Rachael C Walker; Karen Yeates; Alexander Zemchenkov; Ming-Hui Zhao; Simon J Davies; Fergus J Caskey Journal: Kidney Int Suppl (2011) Date: 2020-02-19