Table 2.
Relevance of the six SDG transformations for global kidney health
| SDG transformation | SDGs | How SDGs may impact kidney health and well-being |
|---|---|---|
| Education, gender and inequality | Quality education (SDG 4) | Improve health of families; improve health literacy; improve opportunities to build work workforce |
| Gender equality (SDG 5) | Improve maternal and child health; improve access to care for women and children; study male predominance in kidney failure | |
| Reduced inequalities (SDG 10) | Reduce structural violence; flatten social gradient; address social determinants of health; improve access to screening, early diagnosis and quality treatment; reduce global inequities in access to KRT; reduce imbalance of research and publications skewed to global north | |
| Health, well-being and demography | No poverty (SDG 1) | Improve access to health; improve social circumstances, access to education, good nutrition to reduce incidence of kidney disease; reduce catastrophic health expenditure imposed by kidney disease |
| Good health and well-being (SDG 3) | Increase access to early diagnosis and care under universal health coverage; improve equitable access to prevention, early diagnosis and all treatment; assure quality care; improve well-being and reduce moral distress among health-care workers where resources are limited; develop guidelines for optimal kidney care in high- and low-resource settings; improve access to supportive and palliative care if dialysis and transplantation are not available to those who need them | |
| Partnerships for the goals (SDG 17) | Improve international collaboration for capacity building, research advocacy; good governance, transparent priority setting regarding KRT | |
| Energy, decarbonization and sustainable industry | Affordable and clean energy (SDG 7) | Improve infrastructure maintenance to permit dialysis, transplantation; improve efficiency of dialysis; reduce corruption and monopolies |
| Industry, innovation and infrastructure (SDG 9) | Produce dialysis supplies locally; develop new affordable dialysis systems; improve access using mobile technologies; limit industry interference (for example, from the food, beverage, tobacco industry and dialysis industries) | |
| Responsible consumption and production (SDG 12) | Reduce dialysis waste; increase widespread safe dialyzer reuse to reduce costs and/or waste | |
| Climate action (SDG 13) | ‘Green dialysis’; support transplantation, which is more environmentally friendly; reduce emissions by supporting local production of dialysis supplies | |
| Sustainable food, land, water and oceans | Zero hunger (SDG 2) | Improve fetal and childhood nutrition; reduce obesity |
| Clean water and sanitation (SDG 6) | Improve WASH to prevent diarrhoea-associated AKI and other infections; reduce water consumption through re-use of dialysis water | |
| Life below water (SDG 14) | Protect marine life to ensure safe and sustained fish consumption (loss of fish as protein source will increase obesity and increase the risk of CKD) | |
| Life on land (SDG 15) | Reduce deforestation to protect agriculture and employment; forests may be a source of new medicines (traditional) | |
| Sustainable cities and communities | Decent work and economic growth (SDG 8) | Reduce poverty, improve health through employment; create jobs in the health sector; stimulate local economies through local production of dialysis supplies; reduce unemployment among dialysis and transplant recipients |
| Sustainable cities and communities (SDG 11) | Reduce risk of non-communicable diseases in healthy cities; improve access to dialysis through affordable and reliable public transport | |
| Peace, justice and strong institutions (SDG 16) | Improve equity through priority setting and transparent policy making; improve accountability through oversight of policy implementation to determine impact on patients with kidney disease; reduce organ trafficking | |
| Digital revolution for sustainable development | Industry, innovation and infrastructure (SDG 9) | Task shifting, patient education, health-care delivery, research supported through task shifting; improve access to care through telenephrology |
| Partnerships for the goals (SDG 17) | Improve partnerships with communities, health system industry, pharma, public and private sectors to provide maximal equitable and affordable access to kidney care |
AKI, acute kidney injury; CKD, chronic kidney disease; KRT, kidney replacement therapy; SDG, Sustainable Development Goal; WASH, water quality, sanitation and handwashing.