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Worldwide access to treatment for end-stage kidney disease: A systematic review

Liyanage, Thaminda, Ninomiya, Toshiharu, Jha, Vivekanand, Neal, Bruce, Patrice, Halle M., Okpechi, Ikechi, Zhao, Ming-hui, Lv, Jicheng, Garg, Amit X., Knight, John, Rodgers, Anthony, Gallagher, Martin, Kotwal, Sradha, Cass, Alan and Perkovic, Vlado (2015). Worldwide access to treatment for end-stage kidney disease: A systematic review. The Lancet,385(9981):1975-1982.

Document type: Journal Article
Citation counts: Altmetric Score Altmetric Score is 180
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IRMA ID 75039815xPUB800
Title Worldwide access to treatment for end-stage kidney disease: A systematic review
Author Liyanage, Thaminda
Ninomiya, Toshiharu
Jha, Vivekanand
Neal, Bruce
Patrice, Halle M.
Okpechi, Ikechi
Zhao, Ming-hui
Lv, Jicheng
Garg, Amit X.
Knight, John
Rodgers, Anthony
Gallagher, Martin
Kotwal, Sradha
Cass, Alan
Perkovic, Vlado
Journal Name The Lancet
Publication Date 2015
Volume Number 385
Issue Number 9981
ISSN 0140-6736   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-84929606033
Start Page 1975
End Page 1982
Total Pages 8
Place of Publication United Kingdom
Publisher The Lancet Publishing Group
HERDC Category C1 - Journal Article (DIISR)
Abstract 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.


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.


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]).


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.
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Created: Tue, 26 Jul 2016, 13:03:55 CST