How can we achieve global equity in provision of renal replacement therapy? 

Published in the World Health Organisation (W.H.O) Bulletin Volume 86, Number 3, March 2008, 161-240
Sarah L White ^a, Steven J Chadban ^b, Stephen Jan ^a, Jeremy R Chapman ^c, Alan Cass ^a

a.  The George Institute for International Health, Royal Prince Alfred Hospital, Missenden Road, Sydney, NSW, Australia.
b.  Central Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia.
c.  Centre for Transplant and Renal Research, Westmead Millennium Institute, Westmead Hospital, Westmead, NSW, Australia.

Conclusions:  The global burden of ESKD is concealed behind statistics which reflect only the number of people treated, not those who die of kidney failure or cardiovascular complications. This is particularly the case for LMIC, where resources to provide RRT are severely limited and where substantial underreporting of ESKD probably reflects a vast unmet need. Attention to both the prevention and management of ESKD is required. Successful RRT programmes have been established in select LMICs, and are testament to the viability of such programmes with the appropriate mix of local factors. Dialysis and transplant services need to be affordable, cost-effective and suited to local circumstances. The economic and quality-of-life advantages of transplantation make it an attractive modality over dialysis, and coordinated efforts to facilitate safe and ethical transplantation in LMIC are underway. Overall, global equity in provision of RRT will only be achieved through extensive public, patient and provider education, effective public policy, and ongoing support from international professional bodies, government and nongovernmental organizations. 

International Chronic Kidney Disease Summit for Australia

Kidney Health Australia and the Australian and New Zealand Society of Nephrology (ANZSN) conducted an International Chronic Kidney Disease Summit in Sydney, July 27 2007. 

This meeting addressed the state of play in Australia in regard to CKD - its early detection, best care protocols and resourcing issues.

It showcased the significant progress made in engaging Government in CKD issues in the United States of America and the United Kingdom, and contrasted progress in Australia. 

Read the Summary  of the International CKD Summit and the conclusions reached.

  Australia

• Australian CKD Strategy Workshop Report 2006
• Executive Summary - Australian CKD Strategy 2006
• Australian CKD Statistics
• AusDiab Study Report 2003
• Summary - Economic impact and burden of CKD in Australia
• Economic Impact of the Burden of ESKD in Australia 
• Cost-effectiveness of Early Detection and Intervention to Prevent Progression of CKD in Australia 
• Meeting the Challenge
• Kidney and Urinary Fast Facts

Overseas

• CDC develops Chronic Kidney Disease Initiative USA
• The National Service Framework for Renal Services UK