Nephrology Service, Hospital Civil de Guadalajara, University of Guadalajara Health Sciences Center, Guadalajara, Jalisco, Mexico.
1] Postgraduate Institute of Medical Education and Research, Chandigarh, India [2] George Institute for Global Health, New Delhi, India [3] University of Oxford, Oxford, UK.
Kidney Int. 2015 Feb;87(2):251-3. doi: 10.1038/ki.2014.369.
The increased burden of CKD in disadvantaged 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: expansion of 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 expansion of 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 increased 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.
在弱势群体中，CKD 的负担增加是由于全球因素和特定于人群的问题。社会经济地位低下和难以获得医疗保健服务导致了医疗保健方面的差距，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：通过开发可以在偏远地区实施的低成本替代方案来扩大透析的覆盖面，以及实施和评估具有成本效益的预防策略。应通过扩大已故供体移植计划和使用廉价、通用的免疫抑制剂来促进肾移植。WKD 2015 的信息是，通过增加社区外联、更好的教育、改善经济机会以及为高危人群提供预防医学，对导致 ESRD 的疾病进行协同攻击，可以结束 CKD 和这些社区中弱势群体之间不可接受的关系。
