BMJ:全球终末期肾病患者医疗及护理条件差异研究

2019-11-01 MedSci MedSci原创

综合数据显示,各国有能力为终末期肾病患者提供最佳护理,肾脏疾病的负担、肾脏替代治疗和肾脏管理的能力有很大的差异

近日研究人员考察了全球肾脏替代治疗(透析和移植)与肾脏功能管理能力情况。

研究为国际横断面调查,2018年7月至9月,国际肾病学会(ISN)对182个国家进行了调查。对各地区肾脏替代治疗和肾脏功能管理的国家能力进行标记。

收集来自160个(87.9%)国家资料,占总人口的97.8%。研究发现,肾脏替代治疗和肾脏功能管理的能力和结构差异很大-表现在供资机制、卫生工作人员、提供服务和现有技术等多方面。在全世界218个国家中,有91个国家(42%)提供了关于治疗终末期肾病流行情况的信息,但数据差异多达800多倍,患病率从每百万人口4到3392。卢旺达是唯一报告治疗率数据的低收入国家;53个非洲国家中有5个(<10%)报告了这些数据。在159个国家中,102个国家(64%)为肾脏替代疗法提供了公共资金。159个国家中有68个(43%)在提供免费护理,34个国家(21%)收费。156个国家中有156个(100%)提供血液透析,156个国家中有119个(76%)提供腹膜透析,155个国家中114个(74%)提供肾移植。在154个提供透析和肾移植服务的国家中,只有108个国家(70%)和45个国家(29%)向50%以上的患者提供了透析和肾移植服务。在154个国家中,有124个国家(81%)提供了肾脏功能管理。在世界范围内,肾科医生的中位数为每百万人口9.96人,与收入水平相关。

综合数据显示,各国有能力为终末期肾病患者提供最佳护理,肾脏疾病的负担、肾脏替代治疗和肾脏管理的能力有很大的差异。

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