Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, 301 Mason F. Lord Drive, Suite 2500, Baltimore, MD, 21224, USA.
Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Pediatr Nephrol. 2019 Apr;34(4):541-548. doi: 10.1007/s00467-019-4197-2.
Kidney disease is a global public health problem, affecting over 750 million persons worldwide. The burden of kidney disease varies substantially across the world, as does its detection and treatment. In many settings, rates of kidney disease and the provision of its care are defined by socio-economic, cultural, and political factors leading to significant disparities. World Kidney Day 2019 offers an opportunity to raise awareness of kidney disease and highlight disparities in its burden and current state of global capacity for prevention and management. Here, we highlight that many countries still lack access to basic diagnostics, a trained nephrology workforce, universal access to primary health care, and renal replacement therapies. We point to the need for strengthening basic infrastructure for kidney care services for early detection and management of acute kidney injury and chronic kidney disease across all countries and advocate for more pragmatic approaches to providing renal replacement therapies. Achieving universal health coverage worldwide by 2030 is one of the World Health Organization's Sustainable Development Goals. While universal health coverage may not include all elements of kidney care in all countries, understanding what is feasible and important for a country or region with a focus on reducing the burden and consequences of kidney disease would be an important step toward achieving kidney health equity.
肾脏疾病是一个全球性的公共卫生问题，影响着全球超过 7.5 亿人。肾脏疾病的负担在全球范围内有很大差异，其检测和治疗也是如此。在许多情况下，肾脏疾病的发病率以及对其的护理水平取决于社会经济、文化和政治因素，这导致了显著的差异。2019 年世界肾脏日提供了一个机会，让人们提高对肾脏疾病的认识，并强调其负担和当前全球预防和管理能力方面的差异。在这里，我们强调许多国家仍然缺乏基本诊断、受过培训的肾脏病学劳动力、全民获得初级卫生保健和肾脏替代疗法的机会。我们指出需要加强肾脏护理服务的基本基础设施，以便在所有国家及早发现和管理急性肾损伤和慢性肾脏病，并倡导采取更务实的方法来提供肾脏替代疗法。到 2030 年实现全球全民健康覆盖是世界卫生组织可持续发展目标之一。虽然全民健康覆盖可能并不包括所有国家的肾脏护理的所有内容，但了解对于一个国家或地区来说，什么是可行和重要的，重点是减轻肾脏疾病的负担和后果，这将是实现肾脏健康公平的重要一步。
