Increasing access to integrated ESKD care as part of universal health coverage
Authors: David C.H. Harris, Simon J. Davies, Fredric O. Finkelstein, Vivekanand Jha, Jo-Ann Donner, Georgi Abraham, Aminu K. Bello, Fergus J. Caskey, Guillermo Garcia Garcia, Paul Harden, Brenda Hemmelgarn, David W. Johnson, Nathan W. Levin, Valerie A. Luyckx, Dominique E. Martin, Mignon I. McCulloch, Mohammed Rafique Moosa, Philip J. O’Connell, Ikechi G. Okpechi, Roberto Pecoits Filho, Kamal D. Shah, Laura Sola, Charles Swanepoel, Marcello Tonelli, Ahmed Twahir, Wim van Biesen, Cherian Varghese, Chih-Wei Yang, Carlos Zuniga, Ali K. Abu Alfa, Harith M. Aljubori, Mona N. Alrukhaimi, Sharon P. Andreoli, Gloria Ashuntantang, Ezequiel Bellorin-Font, Bassam Bernieh, Fuad M. Ibhais, Peter G. Blake, Mark Brown, Edwina Brown, Sakarn Bunnag, Tak Mao Chan, Yuqing Chen, Rolando Claure-Del Granado, Stefaan Claus, Allan Collins, Cecile Couchoud, Alfonso Cueto-Manzano, Brett Cullis, Walter Douthat, Gavin Dreyer, Somchai Eiam-Ong, Felicia U. Eke, John Feehally, Mohammad A. Ghnaimat, BakLeong Goh, Mohamed H. Hassan, Fan Fan Hou, Kitty Jager, Kamyar Kalantar-Zadeh, Rumeyza T. Kazancioglu, Adeera Levin, Adrian Liew, Marla McKnight, Yewondwassesn Tadesse Mengistu, Rachael L. Morton, Elmi Muller, Fliss E.M. Murtagh, Saraladevi Naicker, Masaomi Nangaku, Abdou Niang, Gregorio T. Obrador, Shahrzad Ossareh, Jeffrey Perl, Muhibur Rahman, Harun Ur Rashid, Marie Richards, Eric Rondeau, Manisha Sahay, Abdulkarim Saleh, Daniel Schneditz, Irma Tchokhonelidze, Vladimir Tesar, Michele Trask, Kriang Tungsanga, Tushar Vachharajani, Rachael C. Walker, Robert Walker, Anthony J.O. Were, Qiang Yao, Karen Yeates, Xueqing Yu, Elena Zakharova, Alexander Zemchenkov, Ming-Hui Zhao
Journal: Kidney International (2019)

The global nephrology community recognizes the need for a cohesive strategy to address the growing problem of end-stage kidney disease (ESKD). In March 2018, the International Society of Nephrology hosted a summit on integrated ESKD care, including 92 individuals from around the globe with diverse expertise and professional backgrounds. The attendees were from 41 countries, including 16 participants from 11 low- and lower-middle-income countries. The purpose was to develop a strategic plan to improve worldwide access to integrated ESKD care, by identifying and prioritizing key activities across 8 themes: (i) estimates of ESKD burden and treatment coverage, (ii) advocacy, (iii) education and training/workforce, (iv) financing/funding models, (v) ethics, (vi) dialysis, (vii) transplantation, and (viii) conservative care. Action plans with prioritized lists of goals, activities, and key deliverables, and an overarching performance framework were developed for each theme. Examples of these key deliverables include improved data availability, integration of core registry measures and analysis to inform development of health care policy; a framework for advocacy; improved and continued stakeholder engagement; improved workforce training; equitable, efficient, and cost-effective funding models; greater understanding and greater application of ethical principles in practice and policy; definition and application of standards for safe and sustainable dialysis treatment and a set of measurable quality parameters; and integration of dialysis, transplantation, and comprehensive conservative care as ESKD treatment options within the context of overall health priorities. Intended users of the action plans include clinicians, patients and their families, scientists, industry partners, government decision makers, and advocacy organizations. Implementation of this integrated and comprehensive plan is intended to improve quality and access to care and thereby reduce serious health-related suffering of adults and children affected by ESKD worldwide.