Global Kidney Health Atlas

Kidney disease is a significant worldwide public health problem. Acute kidney injury (AKI) and chronic kidney disease (CKD) are linked to high health care costs, poor quality of life, and serious adverse health outcomes.

Despite this burden, kidney disease is often not included in major chronic disease control strategies, presenting an obstacle when engaging with governments to address kidney diseases.

In an attempt to better define the current worldwide state of kidney care for AKI and CKD, and provide policy recommendations for improvements, the ISN launched a global survey project in 2016, the ISN Global Kidney Health Atlas (GKHA), to collect information on the current state of readiness, capacity, and competence for kidney health care delivery in each country and region.


The ISN GKHA is a multinational survey conducted by the ISN to assess current capacity for kidney care. Designed to document the degree to which the six principles of Universal Health Coverage* are available in each country or region, data is gathered on the world status of existing resources, structures, and organizations available to patients with kidney diseases.

The survey was initially administered electronically in 2016 to individuals throughout 130 countries via the ISN’s Affiliated Societies and 10 regional boards. The first global report published in 2017 highlighted kidney disease as a silent epidemic and the neglect of treatment and prevention.

A second, updated ISN GKHA global report published in April 2019, drew attention to the growing burden of kidney diseases and the significant inequities in access to treatment across countries and regions.

*Health Finance, Health Policy, Service Delivery and Safety, Essential Medications and Health Products, Health Information and Statistics, and Health Workforce.

The Reports

ISN GKHA – 1st Edition, 2017

Highlights kidney disease as a silent epidemic and outlines the neglect of treatment and prevention in all countries. An estimated 1 in 10 people worldwide have chronic kidney disease.

ISN GKHA – 2nd Edition, 2019

Highlights the growing burden of kidney disease and significant inequities in access to treatment across countries and regions.

Tools and Resources

Region-specific slides

The ISN GKHA team has prepared summary slides of the ISN GKHA 2019 report focusing on each ISN region individually.

The ISN invites members to share the results from their region with colleagues and key stakeholders to support discussions on and advocate for kidney health care to relevant national and regional health, policy, and education officials.

A user manual and narrative script, in support of the presentation slides, are available to download here in pdf format.

Newly Independent States and Russia

User Manual
Summary Slides
Narrative Script


First ISN GKHA issue published in 2017 (JAMA):
Bello AK, Levin A, Tonelli M, et al. Assessment of Global Kidney Health Care Status. JAMA. 2017;317(18):1864–1881. doi:10.1001/jama.2017.4046

Second issue published in 2019 (BMJ):
Bello AK, Levin A, Lunney M, et al. Status of care for end stage kidney disease in countries and regions worldwide: international cross sectional survey. BMJ. 2019;367:l5873. Published 2019 Oct 31. doi:10.1136/bmj.l5873

Main manuscript

UHC (Universal Health Coverage) domains papers 

UHC (Universal Health Coverage) regional papers 

Other in collaboration with KDIGO

The ISN GKHA reports define the current state of kidney disease care, management, and prevention worldwide, and identify key gaps in specific areas and regions.

This information alerts local and international bodies to the initiatives and health care policies needed to improve outcomes.

Future work will include tools and strategies to address regional and national gaps over the long-term.

ISN GKHA media coverage

Discover the impact of the ISN GKHA through global media coverage.

The ISN GKHA data continues to be collected and analyzed from a balanced representation of national nephrology societies, policymakers, kidney foundations, patient organizations, and advocacy groups.

New editions will be released periodically, tracking progress on the state of readiness, capacity, and competence for the delivery of kidney health care worldwide.

The next issue of the ISN GKHA will be released in 2023.


For any inquiries on the ISN GKHA, contact the ISN Research Team at