An international public-private partnership model for kidney replacement therapy in Uzbekistan: lessons and...

Uzbekistan is an independent country in Central Asia, with a population of 35.6 million and a GDP per capita of $2254. There is a growing need for affordable kidney replacement therapy in the country.

A public-private partnership was established between the Uzbekistan government and a large private hemodialysis provider to enhance access to high-quality, safe, and effective maintenance hemodialysis. We describe the hemodialysis service delivery model, resources, and services, and also the demographics of the patient population, dialysis practices, and programme outcomes from 2022 to December 2024.

In the first phase, hemodialysis facilities were established in three cities: Bogot, Nukus, and Urgench and later in Tashkent. The HD technician/nurse-to-patient ratio was 1:4. Nephrology-trained physicians managed hemodialysis and provided overall supervision. Approximately 46% of patients were between 41 and 60 years old, 58% were male, and 51% had a high school education level. The most common cause of chronic kidney disease was glomerulonephritis (44%). 70% had a functioning arteriovenous fistula, 32% were on three times weekly dialysis, 16% were Hepatitis C positive. Mean follow-up was 351 days. The outcomes were: 26% died, 6% went for a kidney transplant and 47% continued hemodialysis at the same centre. Government hospitals provide support for acute care and biochemical monitoring.

This project showcases an innovative model for delivering hemodialysis care in Uzbekistan, highlighting how the private sector can contribute to closing gaps in healthcare delivery services.