Integrated action needed to tackle health inequalities in European kidney care

Integrated action needed to tackle health inequalities in European kidney care

Experts unite to call for improved access to renal replacement therapy in Europe at the 2014 European Kidney Health Alliance  Spring Forum

No other subject elicits greater emotion than inequalities in access to health care as these deficits affect not only life expectancy but also quality of life. Unequal access to renal replacement therapy illustrates this disparity that persists for European citizens.

The European Kidney Health Alliance (EKHA) together with the MEP Group for Kidney Health – chaired by MEP Mrs Zofija Mazej-Kukovič – brought all key stakeholders together yesterday in the European Parliament in Brussels, including patients, experts and policy makers, to discuss the issues surrounding the provision of  kidney care in Europe. The aim of the EKHA Spring Forum was to unite all stakeholders involved to ensure a better understanding of the problem and to propose solutions.

The inequalities in managing chronic kidney disease (CKD) are especially worrisome, given that today 1 in 10 Europeans suffer from some degree of CKD and experts predict an increase of 17% over the next decade. Prevention and awareness of CKD are crucial to reverse this trend, but more work must be done to provide universal access to high quality kidney care, respecting patients’ choice.

As provision of health care remains an EU Member State competency, this edition of the EKHA Spring Forum highlighted the actual situation in a number of EU countries, as seen in the patient’s, nurse’s and physician’s perspective.   To this end, the special guests of this edition were representatives of national nephrology, transplant, and dialysis associations from 20 countries across the region.  This was followed by input from representatives from the European Commission and key EU health stakeholder EuroHealthNet .

The main types of therapy for end-stage kidney disease (ESKD) are dialysis (both haemodialysis and peritoneal dialysis) or kidney transplantation. Hospital-based dialysis is resource-heavy, costing health systems up to 80,000 euro per patient per year. Home-based dialysis is far less resource-heavy yet is under-used, or not used at all in some Member States, data revealed.

While life-saving, however, dialysis does not offer the same improvement in quality of life as that of a kidney transplant. Transplantation costs roughly the same as  in the first year as hospital-based dialysis, but only a fraction of that in every year following and yields an indefinable quality of life QoL improvement to patients. So why do transplantation rates differ so greatly between Member States? Experts conclude that this is, in part, a result of differing donor legislation, and therefore lack of donor organs, but may also be influenced by the presence of commercial interests in the provision of costly care. Access to various dialysis modalities also differs heavily across borders and experts point to different health systems’ reimbursement rates, efforts to contain costs, and information made available to patients for an informed choice as factors.

While recognising that the European Institutions support advances in kidney care through funding for research and joint actions on prevention of chronic diseases in general, experts agree that there is an urgent need for more integrated action underpinned by evidence. Sharing of best practice guidelines for CKD, examination of barriers to care choice at the national level, and improved awareness of these issues, are first steps towards improved standards of kidney care for Europeans.

This event was made possible with support from Baxter Healthcare, Alexion, Amgen, B. Braun, and Fresenius Medical Care.

About The European Kidney Health Alliance
The European Kidney Health Alliance (EKHA) is an Alliance of not-for-profit organisations who represent the key stakeholders in kidney health issues in Europe.

EKHA takes a multidisciplinary approach involving patients and their families, doctors and nurses, researchers and other healthcare professionals who work cooperatively for a European health environment in which there is a sustained decrease in kidney disease and its consequences.

For more information, please contact:
The agenda of the 2014 EKHA Spring Forum is available here <> . <>
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