Table 1:

Strategies to reduce global burden of ESKD and inequities in access to kidney replacement therapy

1.	Promote a global focus on creating and supporting a culture of health, with an emphasis on primary prevention of CKD.
2.	Increase awareness of CKD as a public health issue among the population, health care providers and policymakers.
3.	Implement effective and affordable early detection, prevention and treatment programs for CKD.  a) Management of non-communicable diseases to include hypertension, diabetes, obesity and cardiovascular disease  b) Blockade of the renin-angiotensin system  c) Prevention of AKI and CKD from environmental exposures (nephrotoxic effects from herbal medicines and contaminated water and soil)  d) Management of communicable diseases to include HIV and waterborne diseases
4.	Develop an appropriate national government policy of KRT delivery to promote equity in resource allocation.
5.	Promote cost-effective home dialysis modality such as peritoneal dialysis and develop affordable dialysis techniques (using domestic manufacturing of dialysis consumables to reduce costs, point-of-care dialysate production).
6.	Lower barriers for patients to receive kidney transplant since it is the most costeffective KRT modality and results in the best clinical outcomes (using generic immunosuppressive drugs).
7.	Finance prevention and treatment of ESKD with a mix of government, private and nongovernmental, not-for-profit funding.
8.	Assess and promote approaches in relation to the local and national levels of economic development and resources through a lens of justice and equity.
9.	Increase manpower resources (nephrologists, nephrology nurses, dialysis technicians, general practitioners).
10.	Educate and train local community experts in partnership with governments, nongovernmental organizations and the pharmaceutical industry.
11.	Implement global evidence-based guidelines and professional standards in the provision of KRT with guidance on ethical issues.