Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Comment
  • Published:

Health policy for universal, sustainable and equitable kidney care

Treatment of chronic kidney disease requires a comprehensive approach including universal access to early diagnosis and to medications that can slow disease progression. Such equitable access is not only an ethical requirement but can also reduce the financial and human costs of advancing kidney and cardiovascular disease.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. Ong, K. L. et al. GBD 2021 Diabetes Collaborators. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 402, 203–234 (2023).

    Article  Google Scholar 

  2. Htay, H. et al. Global access of patients with kidney disease to health technologies and medications: findings from the Global Kidney Health Atlas project. Kidney Int. Suppl. 8, 64–73 (2018).

    Article  Google Scholar 

  3. Neale, E. P. et al. Lifestyle interventions, kidney disease progression, and quality of life: a systematic review and meta-analysis. Kidney Med. 5, 100643 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  4. Lincoff, A. M. et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N. Engl. J. Med. 389, 2221–2232 (2023).

    Article  CAS  PubMed  Google Scholar 

  5. Mark, P. B. et al. SGLT2i for evidence-based cardiorenal protection in diabetic and non-diabetic chronic kidney disease: a comprehensive review by EURECA-m and ERBP working groups of ERA. Nephrol. Dial. Transplant. 38, 2444–2455 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  6. Sarafidis, P. et al. Mineralocorticoid receptor antagonist use in chronic kidney disease with type 2 diabetes: a clinical practice document by the European Renal Best Practice (ERBP) board of the European Renal Association (ERA). Clin. Kidney J. 16, 1885–1907 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  7. Rossing, P. et al. The rationale, design and baseline data of FLOW, a kidney outcomes trial with once-weekly semaglutide in people with type 2 diabetes and chronic kidney disease. Nephrol. Dial. Transplant. 38, 2041–2051 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  8. Neuen, B. L., Perkovic, V., Bakris, G. L., Lambers Heerspink, H. & Vaduganathan, M. Estimated lifetime benefits of combination therapy with SGLT2 inhibitors, GLP-1 receptor agonists, and non-steroidal MRAs in patients with type 2 diabetes and albuminuria. Circulation 148 (Suppl. 1), A17437 (2023).

    Google Scholar 

  9. Nee, R., Yuan, C. M., Narva, A. S., Yan, G. & Norris, K. C. Overcoming barriers to implementing new guideline-directed therapies for chronic kidney disease. Nephrol. Dial. Transplant. 38, 532–541 (2023).

    Article  PubMed  Google Scholar 

  10. de Pouvourville, G. et al. Budget impact analysis of expanding gliflozin coverage in the CKD population: a French perspective. Adv. Ther. 40, 3751–3769 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Laura Solá.

Ethics declarations

Competing interests

The authors declare no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Silvariño, R., Solá, L. Health policy for universal, sustainable and equitable kidney care. Nat Rev Nephrol 20, 147–148 (2024). https://doi.org/10.1038/s41581-024-00811-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41581-024-00811-7

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing