European Kidney Health Alliance, Brussels, Belgium.
Nephrology Section, Department of Internal Medicine and Paediatrics, University Hospital Ghent, Ghent, Belgium.
Nat Rev Nephrol. 2023 Nov;19(11):694-708. doi: 10.1038/s41581-023-00745-6. Epub 2023 Aug 14.
Health inequity refers to the existence of unnecessary and unfair differences in the ability of an individual or community to achieve optimal health and access appropriate care. Kidney diseases, including acute kidney injury and chronic kidney disease, are the epitome of health inequity. Kidney disease risk and outcomes are strongly associated with inequities that occur across the entire clinical course of disease. Insufficient investment across the spectrum of kidney health and kidney care is a fundamental source of inequity. In addition, social and structural inequities, including inequities in access to primary health care, education and preventative strategies, are major risk factors for, and contribute to, poorer outcomes for individuals living with kidney diseases. Access to affordable kidney care is also highly inequitable, resulting in financial hardship and catastrophic health expenditure for the most vulnerable. Solutions to these injustices require leadership and political will. The nephrology community has an important role in advocacy and in identifying and implementing solutions to dismantle inequities that affect kidney health.
健康不公平是指个体或群体实现最佳健康和获得适当医疗的能力存在不必要的和不公平的差异。肾脏疾病，包括急性肾损伤和慢性肾脏病，是健康不公平的缩影。肾脏疾病的风险和结果与疾病整个临床过程中存在的不公平现象密切相关。在肾脏健康和肾脏护理的各个方面投资不足是不公平的根本原因。此外，社会和结构性不公平，包括获得初级卫生保健、教育和预防策略方面的不公平，是导致肾脏疾病患者预后较差的主要危险因素，并促成了这一结果。获得负担得起的肾脏护理也极不公平，使最脆弱的人群面临经济困难和灾难性的健康支出。解决这些不公正问题需要领导层和政治意愿。肾脏病学领域在倡导和确定解决影响肾脏健康的不公平问题的方法方面发挥着重要作用。
