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Chronic kidney disease (CKD) is a significant cause of morbidity and mortality worldwide. The global burden of CKD is estimated at 500 million people worldwide, with the majority of people with CKD (80%) living in low- and middle-income countries (LMICs) (
It had only been 5 years into my taking lithium when my urine turned from golden yellow to a consistent translucent lemonade. As an internal medicine resident and incoming nephrology fellow living with bipolar disorder, I had hoped to have at least 20 years before any renal concentrating deficits began. Lithium had always been my “hero,” albeit imperfect, and hand tremors and nausea seemed a paltry price to pay for the drug's mood-stabilizing and anti-suicidal effects (
For many years, I have been intentionally transparent
You would be hard pressed to find a more capable, resilient, and diverse team of heroes than today's kidney health care workforce. From physicians and nurses to technicians and therapists…from researchers to clinicians to administrative professionals…our field is replete with talented individuals who bring their “all” to achieve equitable, high-quality patient care for the millions of those living with kidney diseases worldwide.
This issue of
With more than 37 million people in the United States affected, chronic kidney disease (CKD) is arguably one of the largest threats to public health outside of the current COVID-19 pandemic. The American Society of Nephrology (ASN) aims to create a world without kidney diseases. To achieve this goal, health equity for all patient populations must be realized, which requires the vanquishing of racial and ethnic disparities in kidney health.
Much like the realities revealed by the COVID-19 pandemic, race-associated disparities in prevalence, morbidity, and mortality outcomes in people with CKD are glaring. These disparities stem directly from structural racism—a
In the United States, diabetes is the leading cause of kidney failure, and the prevalence of diabetes among American Indians and Alaskan Natives (AIs/ANs) is one of the highest among any racial and ethnic group. In the United States, diabetes accounts for 69% of new cases of end stage renal disease (ESRD; diabetes-associated ESRD [ESRD-D]) among the AI/AN population (
The roots of this disparity began in the 1950s and 1960s, when the epidemic of diabetes among the AI/AN population was soon followed by a dramatic increase in diabetic kidney disease and subsequent kidney failure, first described in
It is well established that the best treatment for kidney failure is kidney transplantation and that it should be the treatment of choice for all eligible patients. The greatest economic impacts of kidney transplantation, both living and deceased, are savings to the National Health Service (NHS; the universal health service in the United Kingdom) in dialysis costs (
Donation rates
One of the areas with the most promising potential in nephrology is interventional nephrology. However, paradoxically, it is possibly one of the areas most historically neglected by the specialty itself. Its resurgence in recent years, although not an easy process, reflects a history that is common to the entire nephrology community. In Spain, we have not been oblivious to this process, and now it has become one of the greatest challenges in our specialty.
Diagnostic and interventional nephrology is defined as a discipline that uses imaging and interventional procedures in the kidney patient. Although these techniques were mainly developed by
Australia, like many countries around the world, has experienced a decline in living donor transplantation compared to deceased donors. The 2020 Australia and New Zealand Dialysis and Transplant Registry Annual Report (
Kidney transplantation is the optimal treatment for end stage kidney disease. There are two types of kidney donors—living or deceased—and their proportions vary in different countries. This summary focuses on the living and deceased donation of all organs in Canada, which uses a voluntary opt-in system, where an individual who is eligible to become an organ donor may choose to opt-in to a national or provincial registry.
The total number of kidney transplants performed in Canada in 2019, the last year with data available, was 1483 (
The South East Asian region (SEAR) and South Asian countries (SACs) are divided as high and high-middle economies (HEs), low and lower-middle economies (LEs), and countries not classified due to lack of data (
South Asia and Southeast Asia regional depiction based on economy
