Evidence map›Paper›PMID 39928669›Full record

ArticlePLOS global public health2025

Global availability of medications and health technologies for kidney care: A multinational study from the ISN-GKHA.

Dearbhla M Kelly, Erika S W Jones, Zibya Barday, Silvia Arruebo, Fergus J Caskey, Sandrine Damster, Jo-Ann Donner, Vivekanand Jha, Adeera Levin, Masaomi Nangaku and 6 more

Abstract read
In one paragraph

Article in PLOS global public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Dearbhla M KellyAdult Intensive Care Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.ORCID https://orcid.org/0000-0002-4318-2030
Erika S W JonesDivision of Nephrology and Hypertension, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Western Cape, South Africa.
Zibya BardayDivision of Nephrology and Hypertension, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Western Cape, South Africa.
Silvia ArrueboThe International Society of Nephrology, Brussels, Belgium.
Fergus J CaskeyPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.ORCID https://orcid.org/0000-0002-5199-3925
Sandrine DamsterThe International Society of Nephrology, Brussels, Belgium.
Jo-Ann DonnerThe International Society of Nephrology, Brussels, Belgium.ORCID https://orcid.org/0000-0002-5005-909X
Vivekanand JhaGeorge Institute for Global Health, University of New South Wales (UNSW), New Delhi, India.ORCID https://orcid.org/0000-0002-8015-9470
Adeera LevinDivision of Nephrology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.ORCID https://orcid.org/0000-0003-2438-8401
Masaomi NangakuDivision of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.
Syed SaadDivision of Nephrology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Marcello TonelliDepartment of Medicine, University of Calgary, Calgary, Alberta, Canada.ORCID https://orcid.org/0000-0002-0846-3187
Feng YeDivision of Nephrology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.ORCID https://orcid.org/0000-0003-3601-8395
Ikechi G OkpechiDivision of Nephrology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.ORCID https://orcid.org/0000-0002-6545-9715
Aminu K BelloDivision of Nephrology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
David W JohnsonDepartment of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia.ORCID https://orcid.org/0000-0001-5491-3460

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

A core feature of universal health coverage is equitable access to affordable care not exposing people to financial hardship. This study aims to provide a global overview on availability and access to medications and health technologies for delivery of optimal kidney care. An international survey of stakeholders (clinicians, policymakers, and patient advocates) from countries affiliated to the International Society of Nephrology was conducted from July to September 2022 on availability of tools and services for all aspects of kidney care and access to essential medications. Of 167 participating countries (97.4% of the global population), there were significant disparities in kidney care funding and service availability. Only 5 (n = 1) and 10% (n = 4) of countries in Latin America and Africa, respectively, publicly funded non-dialysis CKD care free at the point of delivery, compared to73% (n = 16) in Western Europe. Public funding (and free at point of delivery) for medications for dialysis and kidney transplantation was available in only 24% (n = 39) and 30% (n = 50) of countries worldwide, with the proportion increasing in line with country income levels. There was reduced capacity for the management of CKD mineral bone disease in low-income countries (LICs) - serum parathyroid hormone was available in only 26% (n = 5) of LICs and the ability to administer non-calcium-based phosphate binders and cinacalcet was also very limited in LICs [16% (n = 3) and 5% (n = 1), respectively]. Nutritional services like oral supplements were accessible in 32% (n = 6) of LICs versus 97% (n = 61) of high-income countries. This study highlights significant gaps in the global methods of funding and availability of medications, capacity for kidney disease monitoring, and capacity to treat complications of kidney disease to improve outcomes. Achieving universal and equitable access to essential medications and health technologies for kidney care is vital to tackle the rapidly growing global burden of kidney disease.

Identifiers

PMID39928669
PMCPMC11809785

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.