Crews Deidra C, Bello Aminu K, Saadi Gamal
Johns Hopkins University School of Medicine, Department of Medicine, Baltimore, Maryland, USA.
Johns Hopkins Medical Institutions, Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, Maryland, USA.
J Bras Nefrol. 2019 Jan-Mar;41(1):1-9. doi: 10.1590/2175-8239-JBN-2018-0224. Epub 2019 Feb 28.
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 towards 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。世界各地肾脏疾病的负担差异很大，其检测和治疗情况也是如此。在许多情况下，肾脏疾病的发病率及其护理服务的提供情况由社会经济、文化和政治因素决定，从而导致显著的差异。2019年世界肾脏日提供了一个机会，以提高人们对肾脏疾病的认识，并突出其负担方面的差异以及全球预防和管理能力的现状。在此，我们强调许多国家仍然无法获得基本诊断、缺乏训练有素的肾脏病专业人员、无法普遍获得初级卫生保健以及肾替代治疗。我们指出，需要加强各国肾脏护理服务的基本基础设施，以便对急性肾损伤和慢性肾脏病进行早期检测和管理，并倡导采取更务实的方法来提供肾替代治疗。到2030年在全球实现全民健康覆盖是世界卫生组织的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肾脏护理的所有要素，但了解对于一个国家或地区而言可行且重要的方面，并侧重于减轻肾脏疾病的负担和后果，将是朝着实现肾脏健康公平迈出的重要一步。
