Epidemiology of end-stage kidney disease.
Semin Vasc Surg
; 34(1): 71-78, 2021 Mar.
Article
in English
| MEDLINE | ID: covidwho-1062789
ABSTRACT
End-stage kidney disease (ESKD) is a common and morbid disease that affects patients' quality and length of life, representing a large portion of health care expenditure in the United States. These patients commonly have associated diabetes and cardiovascular disease, with high rates of cardiovascular-related death. Management of ESKD requires renal replacement therapy via dialysis or transplantation. While transplantation provides the greatest improvement in survival and quality of life, the vast majority of patients are treated initially with hemodialysis. However, outcomes differ significantly among patient populations. Barriers in access to care have particularly affected at-risk populations, such as Black and Hispanic patients. These patients receive less pre-ESKD nephrology care, are less likely to initiate dialysis with a fistula, and wait longer for transplants-even in pediatric populations. Priorities for ESKD care moving into the future include increasing access to nephrology care in underprivileged populations, providing patient-centered care based on each patient's "life plan," and focusing on team-based approaches to ESKD care. This review explores ESKD from the perspective of epidemiology, costs, vascular access, patient-reported outcomes, racial disparities, and the impact of the COVID-19 crisis.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Renal Dialysis
/
Pandemics
/
COVID-19
/
Kidney Failure, Chronic
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Semin Vasc Surg
Journal subject:
Vascular Diseases
Year:
2021
Document Type:
Article
Affiliation country:
J.semvascsurg.2021.02.010
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