Access to Dialysis for Acute Kidney Injury in Low-Resource Settings

Brett Cullis; Viviane Calice da Silva; Mignon McCulloch; Ifeoma Ulasi; Eranga Wijewickrama; Arpana Iyengar

doi:10.1016/j.semnephrol.2023.151313

Access to Dialysis for Acute Kidney Injury in Low-Resource Settings

Semin Nephrol. 2022 Sep;42(5):151313. doi: 10.1016/j.semnephrol.2023.151313. Epub 2023 Feb 22.

Authors

Brett Cullis¹, Viviane Calice da Silva², Mignon McCulloch³, Ifeoma Ulasi⁴, Eranga Wijewickrama⁵, Arpana Iyengar⁶

Affiliations

¹ Department of Paediatrics and Child Health, University of Cape Town, Rondebosch, South Africa; Renal Unit, Hilton Life Hospital, Hilton, South Africa. Electronic address: Brett.cullis@gmail.com.
² Research Department, Pro-Rim Foundation, Joinville, Brazil.
³ Department of Paediatrics and Child Health, University of Cape Town, Rondebosch, South Africa.
⁴ Renal Unit, Department of Medicine, College of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria.
⁵ Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
⁶ Department of Pediatric Nephrology, St John's Medical College Hospital, Bangalore, India.

PMID: 36821914
DOI: 10.1016/j.semnephrol.2023.151313

Abstract

Acute kidney injury (AKI) is estimated to occur in approximately 13.3 million patients per year with an estimated mortality of 1.7 million. Approximately 85% of cases occur in low-resource settings where access to kidney replacement therapy (KRT) may be limited or nonexistent. The true extent of AKI, including access to KRT in developing countries, is largely unknown because appropriate systems are not in place to detect AKI or report it. Barriers to provision of KRT in low-resource settings revolve around systems management and funding, however, there also are region-specific issues. This review focuses on the epidemiology, obstacles, and solutions to improving access to KRT for AKI.

Keywords: Acute kidney injury; access; developing country; dialysis; low resource; peritoneal dialysis.

Publication types

Review

MeSH terms

Acute Kidney Injury* / diagnosis
Acute Kidney Injury* / epidemiology
Acute Kidney Injury* / therapy
Humans
Renal Dialysis*
Renal Replacement Therapy