02995nas a2200505   4500000000100000008004100001260001700042653001000059653001100069653000900080653001600089653001500105653002100120653001500141653002200156653001000178653001600188653001100204653002000215653001800235653007300253653005000326653004300376100001600419700001200435700001000447700001600457700001200473700001700485700001400502700001100516700001500527700001500542700001200557700001400569700001900583700001800602700001500620245008400635250001500719300001200734490000800746520168400754020005102438       2015                            d  c-4560371845110aAdult10aHumans10aAged10aMiddle Aged10aAdolescent10aChild, Preschool10aPrevalence10aAged, 80 and over10aChild10aYoung Adult10aInfant10aInfant, Newborn10aGlobal Health10aHealth Services Accessibility/standards/ statistics & numerical data10aKidney Failure, Chronic/epidemiology/ therapy10aRenal Replacement Therapy/ utilization1 aLiyanage T.1 aGarg A.1 aLv J.1 aNinomiya T.1 aCass A.1 aGallagher M.1 aKnight J.1 aJha V.1 aPatrice H.1 aOkpechi I.1 aZhao M.1 aRodgers A1 aPerkovic Vlado1 aKotwal Sradha1 aNeal Bruce00aWorldwide access to treatment for end-stage kidney disease: a systematic review  a2015/03/18  a1975-820 v3853 a<p>
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. FUNDING: Australian National Health and Medical Research Council.
</p>
  a1474-547X (Electronic)<br/>0140-6736 (Linking)