Garcia-Garcia Guillermo, Jha Vivekanand
1 Nephrology Service, Hospital Civil de Guadalajara University of Guadalajara Health Sciences Center Guadalajara, Jalisco, Mexico. 2 Postgraduate Institute of Medical Education and Research, Chandigarh, India. 3 George Institute for Global Health, New Delhi, India. 4 University of Oxford, Oxford, UK.
Transplantation. 2015 Jan;99(1):13-6. doi: 10.1097/TP.0000000000000558.
The increased burden of CKD in disadavantaged populations is due to both global factors and population-specific issues. Low socioeconomic status and poor access to care contribute to health care disparities, and exacerbate the negative effects of genetic or biologic predisposition. Provision of appropriate renal care to these populations requires a two-pronged approach: expanding the reach of dialysis through development of low-cost alternatives that can be practiced in remote locations, and implementation and evaluation of cost-effective prevention strategies. Kidney transplantation should be promoted by expanding deceased donor transplant programs and use of inexpensive, generic immunosuppressive drugs. The message of WKD 2015 is that a concerted attack against the diseases that lead to ESRD, by increasing community outreach, better education, improved economic opportunity, and access to preventive medicine for those at highest risk, could end the unacceptable relationship between CKD and disadvantage in these communities.
弱势群体中慢性肾脏病负担的增加是全球因素和特定人群问题共同作用的结果。社会经济地位低下和医疗服务可及性差导致了医疗保健方面的差异，并加剧了遗传或生物学易感性的负面影响。为这些人群提供适当的肾脏护理需要采取双管齐下的方法：通过开发可在偏远地区实施的低成本替代方案来扩大透析服务范围，并实施和评估具有成本效益的预防策略。应通过扩大 deceased donor 移植项目以及使用廉价的通用免疫抑制药物来促进肾脏移植。2015年世界肾脏日传达的信息是，通过加强社区宣传、改善教育、增加经济机会以及为高危人群提供预防医学服务，协同对抗导致终末期肾病的疾病，有可能终结这些社区中慢性肾脏病与弱势群体之间不可接受的关联。 （注：“deceased donor”可能是“已故捐赠者”之类的意思，具体准确含义需结合专业背景进一步确定）
