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Abstract: PO1184

Workforce Capacity for ESKD Care: An Analysis from the Global Kidney Health Atlas Study

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Riaz, Parnian, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
  • Osman, Mohamed A., University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
  • Lunney, Meaghan, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
  • Ye, Feng, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
  • Saad, Syed, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
  • Levin, Adeera, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
  • Johnson, David W., The University of Queensland Faculty of Medicine, Herston, Queensland, Australia
  • Bello, Aminu K., University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada

Group or Team Name

  • Global Kidney Health Atlas Investigators
Background

Despite the rising burden of chronic kidney disease, recent surveys reveal a global shortage of nephrologists and other kidney healthcare professionals. The objective of the second iteration of the International Society of Nephrology's (ISN) Global Kidney Health Atlas was to assess inter- and intra-national variability in the capacity for end-stage kidney disease (ESKD) care.

Methods

Data were collected in two steps: desk research and a cross-sectional survey. Desk research used data from online sources, such as the Central Intelligence Agency World Factbook and the World Health Organization Global Observatory. The survey was administered online to key stakeholders worldwide, and all country-level data were analyzed by ISN region and World Bank income classification.

Results

The results of desk research showed that the general healthcare workforce density varied by income level: high income countries had more healthcare workers per 10,000 population (30.30 physicians; 79.21 nursing personnel; 7.20 pharmacists; 3.47 surgeons) than low income countries (0.85 physicians; 5.02 nursing personnel; 0.10 pharmacists; 0.03 surgeons). A total of 182 countries responded to the survey, with 160 (88%) countries responding to questions pertaining to the ESKD workforce. Nephrologists were primarily responsible for providing care to ESKD patients in 92% of countries. Global nephrologist density was 9.95 per million population (pmp) and nephrology trainee density was 1.42 pmp. High income countries reported the highest densities of nephrologists and nephrology trainees (23.15 pmp and 3.83 pmp, respectively), whereas low income countries reported the lowest densities (0.24 pmp and 0.11 pmp, respectively). Compared to higher income countries, more low income countries reported shortages of all types of ESKD healthcare providers, including nephrologists, transplant surgeons, peritoneal and hemodialysis access surgeons, and peritoneal and hemodialysis access interventional radiologists.

Conclusion

In this global survey, a significant trend was demonstrated in workforce capacity and distribution for ESKD care across countries. There was limited capacity in low income compared to high income countries. National and international policies are required to build a workforce that can effectively address the growing burden of ESKD.