Capacity for the management of kidney failure in the International Society of Nephrology Oceania and South East Asia (OSEA) region: report from the 2023 ISN Global Kidney Health Atlas (ISN-GKHA)

• Published in: KIDNEY INTERNATIONAL SUPPLEMENTS
• Main Authors: Francis, Anna; Wainstein, Marina; Irish, Georgina; Hafidz, Muhammad Iqbal Abdul; Chen, Titi; Cho, Yeoungjee; Htay, Htay; Kanjanabuch, Talerngsak; Lalji, Rowena; Neuen, Brendon L.; See, Emily; Shah, Anim; Smyth, Brendan; Tungsanga, Somkanya; Viecelli, Andrea; Yeung, Emily K.; Arruebo, Silvia; K.Bello, Aminu; Caskey, Fergus J.; Damster, Sandrine; Donner, Jo-Ann; Jha, Vivekanand; Johnson, David W.; Levin, Adeera; Malik, Charu; Nangaku, Masaomi; Okpechi, Ikechi G.; Tonelli, Marcello; Ye, Feng; Wong, Muh Geot; Bavanandan, Sunita
• Format: Article
• Language: English
• Published: ELSEVIER SCIENCE INC 2024
• Subjects: Urology & Nephrology
• Online Access: https://www-webofscience-com.uitm.idm.oclc.org/wos/woscc/full-record/WOS:001230298500001
• ISSN: 2157-1724; 2157-1716
• DOI: 10.1016/j.kisu.2024.01.004

The International Society of Nephrology (ISN) region of Oceania and South East Asia (OSEA) is a mix of high- and low-income countries, with diversity in population demographics and densities. Three iterations of the ISNGlobal Kidney Health Atlas (GKHA) have been conducted, aiming to deliver in-depth assessments of global kidney care across the spectrum from early detection of CKD to treatment of kidney failure. This paper reports the findings of the latest ISN-GKHA in relation to kidney -care capacity in the OSEA region. Among the 30 countries and territories in OSEA, 19 (63%) participated in the ISN-GKHA, representing over 97% of the region 's population. The overall prevalence of treated kidney failure in the OSEA region was 1203 per million population (pmp), 45% higher than the global median of 823 pmp. In contrast, kidney replacement therapy (KRT) in the OSEA region was less available than the global median (chronic hemodialysis, 89% OSEA region vs. 98% globally; peritoneal dialysis, 72% vs. 79%; kidney transplantation, 61% vs. 70%). Only 56% of countries could provide access to dialysis to at least half of people with incident kidney failure, lower than the global median of 74% of countries with available dialysis services. Inequalities in access to KRT were present across the OSEA region, with widespread availability and low out-of-pocket costs in high -income countries and limited availability, often coupled with large out-of-pocket costs, in middleand low-income countries. Workforce limitations were observed across the OSEA region, especially in lowermiddle -income countries. Extensive collaborative work within the OSEA region and globally will help close the noted gaps in kidney -care provision.