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Hemodialysis Use and Practice Patterns: An International Survey Study
Htay Htay1, Aminu K Bello2, Adeera Levin3
1Department of Renal Medicine, Singapore General Hospital, Singapore.
Summary
Global hemodialysis (HD) use and quality vary significantly, with lower-income nations facing greater challenges in access and affordability for this vital kidney replacement therapy.
Area of Science:
- Nephrology
- Public Health
- Global Health Equity
Background:
- Hemodialysis (HD) is the predominant form of kidney replacement therapy worldwide.
- Significant disparities in HD care access and quality are suspected globally.
Purpose of the Study:
- To comprehensively assess the global landscape of hemodialysis care.
- Examining use, availability, accessibility, affordability, and quality of HD services across diverse economic settings.
Main Methods:
- A global cross-sectional survey was conducted.
- International Society of Nephrology convened stakeholders from 182 countries in 2018.
- Descriptive statistics were employed to analyze collected data.
Main Results:
- HD use varied widely, with lower rates in low-income countries.
- Adequate HD services were available in only 27% of low-income countries.
- Significant financial barriers and suboptimal vascular access practices were noted, particularly in lower-income nations.
Conclusions:
- Substantial global disparities exist in hemodialysis utilization, availability, accessibility, quality, and affordability.
- Low- and lower-middle-income countries face the most significant challenges in HD care provision.
Keywords:
ESKD careHD accessibilityHD affordabilityHD availabilityHemodialysis (HD)RRT modalityend-stage kidney disease (ESKD)funding for HD servicesglobal surveyhealth care deliveryhealth care disparitieshealth policyinternational differenceskidney failurequality of HD servicesrenal replacement therapy (RRT)
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