Capacity for the management of kidney failure in the International Society of Nephrology Newly Independent States and Russia region: report from the 2023 ISN Global Kidney Health Atlas (ISN-GKHA)

Abstract

The International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA) was established to aid understanding of the status and capacity of countries to provide optimal kidney care worldwide. This report presents the current characteristics of kidney care in the ISN Newly Independent States (NIS) and Russia region. Although the median prevalence of chronic kidney disease (CKD) was higher (11.4%) than the global median (9.5%), the median CKD-related death rate (1.4%) and prevalence of treated kidney failure (KF) in the region (411 per million population [pmp]) were lower than they are globally (2.5% and 822.8 pmp, respectively). Capacity to provide an adequate frequency of hemodialysis (HD) and kidney transplantation services is present in all the countries (100%). In spite of significant economic advancement, the region has critical shortages of nephrologists, dietitians, transplant coordinators, social workers, palliative care physicians, and kidney supportive care nurses. Home HD remains unavailable in any country in the region. Although national registries for dialysis and kidney transplantation are available in most of the countries across the ISN NIS and Russia region, few registries exist for nondialysis CKD and acute kidney injury. Although a national strategy for improving care for CKD patients is presented in more than half of the countries, no country in the region had a CKD-specific policy. Strategies that incorporate workforce training, planning, and development for all KF caregivers could help ensure sustainable kidney care delivery in the ISN NIS and Russia region.

Keywords: NIS and Russia; chronic kidney disease; health workforce; kidney failure; kidney replacement therapy.

Figure 1

Countries in the International Society of Nephrology Newly Independent States and Russia region.

Figure 2

Funding structures for nondialysis chronic kidney disease (CKD) and kidney replacement therapy (KRT), globally and in the International Society of Nephrology Newly Independent States and Russia region. Values represent absolute number of countries in each category expressed as a percentage of the total number of countries. AKI, acute kidney injury; HD, hemodialysis; N/A, not available; NGOs, nongovernmental organizations; PD, peritoneal dialysis.

Figure 3

Availability of choice in kidney replacement therapy or conservative kidney management (CKM) for people with kidney failure in the International Society of Nephrology Newly Independent States and Russia region. Values represent absolute number of countries in each category expressed as a percentage of the total number of countries. HD, hemodialysis; Kt/V, (dialyzer clearance of urea × dialysis time)/volume; N/A, not available; PD, peritoneal dialysis; URR, urea reduction ratio.

Figure 4

Accessibility of kidney replacement therapy (KRT) for people with kidney failure (KF), globally and in the International Society of Nephrology Newly Independent States (NIS) and Russia region. Values represent absolute number of countries in each category expressed as a percentage of total number of countries. N/A, not available; PD, peritoneal dialysis.

Figure 5

Country-level scorecard showing availability of kidney replacement therapy (KRT) and conservative kidney management (CKM), funding of medications, registry, and advocacy groups in the International Society of Nephrology Newly Independent States and Russia region, 2019 and 2023. Funding for medications refers to 100% public funding by the government (free at the point of delivery). AKI, acute kidney injury; CKD, chronic kidney disease; HD, hemodialysis; KRT, kidney replacement therapy; N/A, not available; PD, peritoneal dialysis; PMP, per million population.