Workforce capacity for the care of patients with kidney failure across world countries and regions

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Introduction

An effective workforce is essential for optimal care of all forms of chronic diseases. The objective of this study was to assess workforce capacity for kidney failure (KF) care across world countries and regions.

Methods

Data were collected from published online sources and a survey was administered online to key stakeholders. All country-level data were analysed by International Society of Nephrology region and World Bank income classification.

Results

The general healthcare workforce varies by income level: high-income countries have more healthcare workers per 10 000 population (physicians: 30.3; nursing personnel: 79.2; pharmacists: 7.2; surgeons: 3.5) than low-income countries (physicians: 0.9; nursing personnel: 5.0; pharmacists: 0.1; surgeons: 0.03). A total of 160 countries responded to survey questions pertaining to the workforce for the management of patients with KF. The physicians primarily responsible for providing care to patients with KF are nephrologists in 92% of countries. Global nephrologist density is 10.0 per million population (pmp) and nephrology trainee density is 1.4 pmp. High-income countries reported the highest densities of nephrologists and nephrology trainees (23.2 pmp and 3.8 pmp, respectively), whereas low-income countries reported the lowest densities (0.2 pmp and 0.1 pmp, respectively). Low-income countries were most likely to report shortages of all types of healthcare providers, including nephrologists, surgeons, radiologists and nurses.

Conclusions

Results from this global survey demonstrate critical shortages in workforce capacity to care for patients with KF across world countries and regions. National and international policies will be required to build a workforce capacity that can effectively address the growing burden of KF and deliver optimal care.

Related collections

Most cited references 31

Record: found
Abstract: found
Article: found

Is Open Access

Global Prevalence of Chronic Kidney Disease – A Systematic Review and Meta-Analysis

Nathan Hill, Samuel T Fatoba, Jason L. Oke … (2016)

Chronic kidney disease (CKD) is a global health burden with a high economic cost to health systems and is an independent risk factor for cardiovascular disease (CVD). All stages of CKD are associated with increased risks of cardiovascular morbidity, premature mortality, and/or decreased quality of life. CKD is usually asymptomatic until later stages and accurate prevalence data are lacking. Thus we sought to determine the prevalence of CKD globally, by stage, geographical location, gender and age. A systematic review and meta-analysis of observational studies estimating CKD prevalence in general populations was conducted through literature searches in 8 databases. We assessed pooled data using a random effects model. Of 5,842 potential articles, 100 studies of diverse quality were included, comprising 6,908,440 patients. Global mean(95%CI) CKD prevalence of 5 stages 13·4%(11·7–15·1%), and stages 3–5 was 10·6%(9·2–12·2%). Weighting by study quality did not affect prevalence estimates. CKD prevalence by stage was Stage-1 (eGFR>90+ACR>30): 3·5% (2·8–4·2%); Stage-2 (eGFR 60–89+ACR>30): 3·9% (2·7–5·3%); Stage-3 (eGFR 30–59): 7·6% (6·4–8·9%); Stage-4 = (eGFR 29–15): 0·4% (0·3–0·5%); and Stage-5 (eGFR<15): 0·1% (0·1–0·1%). CKD has a high global prevalence with a consistent estimated global CKD prevalence of between 11 to 13% with the majority stage 3. Future research should evaluate intervention strategies deliverable at scale to delay the progression of CKD and improve CVD outcomes.

0 comments Cited 845 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Is Open Access

Analysis of the Global Burden of Disease study highlights the global, regional, and national trends of chronic kidney disease epidemiology from 1990 to 2016

Cheng-You Tsai, Tasheia Floyd, Geetha Maddukuri … (2018)

The last quarter century witnessed significant population growth, aging, and major changes in epidemiologic trends, which may have shaped the state of chronic kidney disease (CKD) epidemiology. Here, we used the Global Burden of Disease study data and methodologies to describe the change in burden of CKD from 1990 to 2016 involving incidence, prevalence, death, and disability-adjusted-life-years (DALYs). Globally, the incidence of CKD increased by 89% to 21,328,972 (uncertainty interval 19,100,079- 23,599,380), prevalence increased by 87% to 275,929,799 (uncertainty interval 252,442,316-300,414,224), death due to CKD increased by 98% to 1,186,561 (uncertainty interval 1,150,743-1,236,564), and DALYs increased by 62% to 35,032,384 (uncertainty interval 32,622,073-37,954,350). Measures of burden varied substantially by level of development and geography. Decomposition analyses showed that the increase in CKD DALYs was driven by population growth and aging. Globally and in most Global Burden of Disease study regions, age-standardized DALY rates decreased, except in High-income North America, Central Latin America, Oceania, Southern Sub-Saharan Africa, and Central Asia, where the increased burden of CKD due to diabetes and to a lesser extent CKD due to hypertension and other causes outpaced burden expected by demographic expansion. More of the CKD burden (63%) was in low and lower-middle-income countries. There was an inverse relationship between age-standardized CKD DALY rate and health care access and quality of care. Frontier analyses showed significant opportunities for improvement at all levels of the development spectrum. Thus, the global toll of CKD is significant, rising, and unevenly distributed; it is primarily driven by demographic expansion and in some regions a significant tide of diabetes. Opportunities exist to reduce CKD burden at all levels of development.

0 comments Cited 344 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Chronic kidney disease.

Andrew Levey, Josef Coresh (2012)

Chronic kidney disease is a general term for heterogeneous disorders affecting kidney structure and function. The 2002 guidelines for definition and classification of this disease represented an important shift towards its recognition as a worldwide public health problem that should be managed in its early stages by general internists. Disease and management are classified according to stages of disease severity, which are assessed from glomerular filtration rate (GFR) and albuminuria, and clinical diagnosis (cause and pathology). Chronic kidney disease can be detected with routine laboratory tests, and some treatments can prevent development and slow disease progression, reduce complications of decreased GFR and risk of cardiovascular disease, and improve survival and quality of life. In this Seminar we discuss disease burden, recommendations for assessment and management, and future challenges. We emphasise clinical practice guidelines, clinical trials, and areas of uncertainty. Copyright © 2012 Elsevier Ltd. All rights reserved.

0 comments Cited 291 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): BMJ Glob Health

Journal ID (iso-abbrev): BMJ Glob Health

Journal ID (hwp): bmjgh

Journal ID (publisher-id): bmjgh

Title: BMJ Global Health

Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )

ISSN (Electronic): 2059-7908

Publication date Collection: 2021

Publication date (Electronic): 18 January 2021

Volume: 6

Issue: 1

Electronic Location Identifier: e004014

Affiliations

[1 ]departmentMedicine , University of Alberta Faculty of Medicine and Dentistry , Edmonton, Alberta, Canada

[2 ]departmentPopulation Health Sciences , University of Bristol , Bristol, UK

[3 ]departmentFaculty of Medicine and Health Sciences , Stellenbosch University , Cape Town, South Africa

[4 ]departmentMedicine , Singapore General Hospital , Singapore

[5 ]departmentGeorge Institute for Global Health , University of New South Wales (UNSW) , New Delhi, India

[6 ]departmentMedicine , University of Alberta , Edmonton, Alberta, Canada

[7 ]The George Institute for Global Health , Newtown, New South Wales, Australia

[8 ]departmentFaculty of Science , University of Alberta , Edmonton, Alberta, Canada

[9 ]departmentDivision of Nephrology , University of British Columbia , Vancouver, British Columbia, Canada

[10 ]departmentDepartment of Community Health Sciences , University of Calgary , Calgary, Alberta, Canada

[11 ]departmentMedicine , University of Cape Town , Cape Town, South Africa

[12 ]departmentSchool of Medicine , Pontifical Catholic University of Paraná , Curitiba, Brazil

[13 ]departmentDepartment of Nephrology and Hypertension , Cleveland Clinic, Glickman Urological and Kidney Institute , Cleveland, Ohio, USA

[14 ]University of Sydney at Westmead Hospital , Westmead, New South Wales, Australia

[15 ]departmentDepartment of Medicine , University of Calgary , Calgary, Alberta, Canada

[16 ]departmentDepartment of Nephrology, Metro South and Ipswich Nephrology and Transplant Services (MINTS) , Princess Alexandra Hospital , Brisbane, Queensland, Australia

Author notes

[Correspondence to ] Dr Aminu Bello; aminu1@ 123456ualberta.ca

Author information

Ikechi Okpechi http://orcid.org/0000-0002-6545-9715

Article

Publisher ID: bmjgh-2020-004014

DOI: 10.1136/bmjgh-2020-004014

PMC ID: 7816926

PubMed ID: 33461978

SO-VID: f3d14228-8f23-4f51-a5af-a22a3ccf8317

License:

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

History

Date received : 21 September 2020

Date revision received : 19 December 2020

Date accepted : 23 December 2020

Funding

Funded by: FundRef http://dx.doi.org/10.13039/100009891, International Society of Nephrology;

Award ID: RES0033080

Custom metadata

special-feature unlocked

Keywords: epidemiology,health services research,public health

Data availability:

Keywords: epidemiology, health services research, public health

Comments

Comment on this article

scite_

Cited by 16

See all cited by

Most referenced authors 2,012

See all reference authors

Workforce capacity for the care of patients with kidney failure across world countries and regions

Read this article at

Abstract

Introduction

Methods

Results

Conclusions

Related collections

AIP Publishing: Coronavirus

Most cited references 31

Global Prevalence of Chronic Kidney Disease – A Systematic Review and Meta-Analysis

Analysis of the Global Burden of Disease study highlights the global, regional, and national trends of chronic kidney disease epidemiology from 1990 to 2016

Chronic kidney disease.

Author and article information

Journal

Affiliations

Author notes

Author information

Article

History

Funding

Categories

Custom metadata

Comments

Comment on this article

Similar content 82

Cited by 16

Most referenced authors 2,012