|Worldwide access to treatment for end-stage kidney disease: a systematic review|
|Liyanage, Thaminda1,2; Ninomiya, Toshiharu1; Jha, Vivekanand3,4,5; Neal, Bruce1; Patrice, Halle Marie6; Okpechi, Ikechi7; Zhao, Ming-hui8; Lv, Jicheng8; Garg, Amit X.9,10; Knight, John1; Rodgers, Anthony1; Gallagher, Martin1; Kotwal, Sradha1; Cass, Alan1,11; Perkovic, Vlado1,2|
|WOS标题词||Science & Technology|
|类目[WOS]||Medicine, General & Internal|
|研究领域[WOS]||General & Internal Medicine|
|关键词[WOS]||GLOBAL BURDEN ; RENAL-DISEASE ; CARE ; METAANALYSIS ; PROGRESSION ; DIALYSIS ; OUTCOMES ; FAILURE ; PROGRAM ; TRENDS|
Background End-stage kidney disease is a leading cause of morbidity and mortality worldwide. Prevalence of the disease and worldwide use of renal replacement therapy (RRT) are expected to rise sharply in the next decade. We aimed to quantify estimates of this burden.
Methods We systematically searched Medline for observational studies and renal registries, and contacted national experts to obtain RRT prevalence data. We used Poisson regression to estimate the prevalence of RRT for countries without reported data. We estimated the gap between needed and actual RRT, and projected needs to 2030.
Findings In 2010, 2.618 million people received RRT worldwide. We estimated the number of patients needing RRT to be between 4.902 million (95% CI 4.438-5.431 million) in our conservative model and 9.701 million (8.544-11.021 million) in our high-estimate model, suggesting that at least 2.284 million people might have died prematurely because RRT could not be accessed. We noted the largest treatment gaps in low-income countries, particularly Asia (1.907 million people needing but not receiving RRT; conservative model) and Africa (432 000 people; conservative model). Worldwide use of RRT is projected to more than double to 5.439 million (3.899-7.640 million) people by 2030, with the most growth in Asia (0.968 million to a projected 2.162 million [1.571-3.014 million]).
Interpretation The large number of people receiving RRT and the substantial number without access to it show the need to both develop low-cost treatments and implement effective population-based prevention strategies.
|资助机构||Australian National Health and Medical Research Council Program Grant|
|作者单位||1.Royal N Shore Hosp, Sydney, NSW, Australia|
2.George Inst Global Hlth, Splendor Forum, Jasola New Delhi, India
3.Univ Oxford, Nuffield Dept Populat Hlth, Oxford, England
4.Univ Douala, Fac Med, Dept Clin Sci, Douala, Cameroon
5.Univ Sydney, George Inst Global Hlth, Sydney, NSW 2050, Australia
6.Postgrad Inst Med Educ & Res, Dept Nephrol, Chandigarh 160012, India
7.Univ Cape Town, Div Internal Med, ZA-7925 Cape Town, South Africa
8.Peking Univ, Dept Med, Div Renal, Hosp 1, Beijing 100871, Peoples R China
9.Univ Western Ontario, Dept Med, London, ON, Canada
10.Univ Western Ontario, Dept Epidemiol & Biostat, London, ON, Canada
11.Charles Darwin Univ, Menzies Sch Hlth Res, Darwin, NT 0909, Australia
|Liyanage, Thaminda,Ninomiya, Toshiharu,Jha, Vivekanand,et al. Worldwide access to treatment for end-stage kidney disease: a systematic review[J]. LANCET,2015,385(9981):1975-1982.|
|APA||Liyanage, Thaminda.,Ninomiya, Toshiharu.,Jha, Vivekanand.,Neal, Bruce.,Patrice, Halle Marie.,...&Perkovic, Vlado.(2015).Worldwide access to treatment for end-stage kidney disease: a systematic review.LANCET,385(9981),1975-1982.|
|MLA||Liyanage, Thaminda,et al."Worldwide access to treatment for end-stage kidney disease: a systematic review".LANCET 385.9981(2015):1975-1982.|