Closing the Gaps

CKD ‘Closing the Gaps’




The ISN CKD ‘Closing the Gaps’ initiative will provide a comprehensive strategy to address issues related to chronic kidney disease (CKD) care delivery worldwide. The strategy involves international leaders to understand and address issues related to gaps in clinical care delivery, research and advocacy.

Through different projects, ‘Closing the Gaps’ sets out to define the global needs, the current state and a ’blueprint’ for moving forward and closing the gaps in CKD care, using research, education and advocacy activities.

It is a complementary strategy to the ISN 0by25 initiative (, which aims to eliminate preventable deaths from acute kidney injury (AKI) worldwide by 2025.


Kidney disease is increasingly seen as a public health problem, a risk multiplier for many other conditions, and for its association with cardio-vascular diseases, diabetes and infections. Its fastest growth rate is in low- and low-middle-income countries, which will require support to face the challenge of this growth.

Although renal replacement therapy has been available for decades in high-income countries, relatively little is known about the optimal way to coordinate, finance and regulate the care for people with CKD throughout the spectrum ( from diagnosis, care and access to renal replacement therapies). Throughout the world inequalities exist within emerging countries as well as in wealthier countries.



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