Conservative Kidney Management in the Middle East and North Africa: Attitudes, Practices, and Implementation Barriers
Introduction: Conservative kidney management (CKM) is poorly developed and not easily accessible globally, especially in middle- and low-income countries. This study aimed to understand the perspectives of nephrologists on CKM and the barriers to its implementation in the Middle East and North Afric...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-04-01
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| Series: | Kidney International Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468024925000117 |
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| author | Sahar H. Koubar Taha Hatab Farah Abdul Razzak Imed Helal Ala Ali Abdulhafid Shebani Saleh Kaysi David Gunderman Akram Al-Makki Sara N. Davison |
| author_facet | Sahar H. Koubar Taha Hatab Farah Abdul Razzak Imed Helal Ala Ali Abdulhafid Shebani Saleh Kaysi David Gunderman Akram Al-Makki Sara N. Davison |
| author_sort | Sahar H. Koubar |
| collection | DOAJ |
| description | Introduction: Conservative kidney management (CKM) is poorly developed and not easily accessible globally, especially in middle- and low-income countries. This study aimed to understand the perspectives of nephrologists on CKM and the barriers to its implementation in the Middle East and North Africa (MENA) region. Methods: We conducted an online survey. Nephrologists were contacted through their local nephrology societies. Responses were divided into the following 3 groups as per the country’s income classification by the World Bank: high-, middle-, and low-income. Results: A total of 336 surveys were analyzed (response rate: 34.28%). The mean age of participants was 43.3 ± 9.8 years; 50% were male, 91% practiced in urban settings, and 18% were affiliated with academic centers. Of the participants, 76% were from middle-income countries. Nearly 80% of the participants were aware of CKM, and 65% accepted CKM as a treatment modality for kidney failure. However, only 20% consistently offered CKM to their patients and only 16% had a formal CKM program at their institution. Among these, 12% had a multidisciplinary team and only 6% had formal CKM training. The major perceived barriers to CKM implementation were financial and resource constraints (37.7% and 32.7%, respectively). Cultural and religious barriers constituted 18.3% and 8.6%, respectively, and were similar among the 3 income groups. Conclusion: Despite the significant awareness of CKM in the MENA region, its implementation remains poor. Key barriers include financial limitations, resource shortages, and a lack of training. Regional and national research is required to address these challenges and guide policies to improve CKM accessibility and implementation. |
| format | Article |
| id | doaj-art-6f977dd22eee44ef986acb57f1c0c0a6 |
| institution | Kabale University |
| issn | 2468-0249 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney International Reports |
| spelling | doaj-art-6f977dd22eee44ef986acb57f1c0c0a62025-08-20T03:47:10ZengElsevierKidney International Reports2468-02492025-04-011041076108610.1016/j.ekir.2025.01.011Conservative Kidney Management in the Middle East and North Africa: Attitudes, Practices, and Implementation BarriersSahar H. Koubar0Taha Hatab1Farah Abdul Razzak2Imed Helal3Ala Ali4Abdulhafid Shebani5Saleh Kaysi6David Gunderman7Akram Al-Makki8Sara N. Davison9Division of Nephrology and Hypertension, University of Minnesota, Minneapolis, Minnesota, USA; Division of Nephrology and Hypertension, Department of Medicine, American University of Beirut, Beirut, Lebanon; Correspondence: Sahar Koubar, Division of Nephrology and Hypertension, University of Minnesota, 717 Delaware Street SE-RM 356, Minneapolis, Minnesota, USA.Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USADepartment of Internal Medicine, Detroit Medical Center/Wayne State University School of Medicine, Detroit, Michigan, USADepartment of Nephrology and Internal Medicine, Charles Nicolle Hospital, Tunis, TunisiaMedical Department, Nephrology and Renal Transplantation Center, Baghdad, IraqNephrology Department, Tripoli University Hospital, Tripoli, LibyaDepartment of Nephrology, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, BelgiumIndiana University Health-Arnett, Indiana University School of Medicine-West Lafayette, West Lafayette, Indiana, USAIndiana University Health-Arnett, Indiana University School of Medicine-West Lafayette, West Lafayette, Indiana, USAFaculty of Medicine and Dentistry, Division of Nephrology and Immunology, University of Alberta, Edmonton, Alberta, CanadaIntroduction: Conservative kidney management (CKM) is poorly developed and not easily accessible globally, especially in middle- and low-income countries. This study aimed to understand the perspectives of nephrologists on CKM and the barriers to its implementation in the Middle East and North Africa (MENA) region. Methods: We conducted an online survey. Nephrologists were contacted through their local nephrology societies. Responses were divided into the following 3 groups as per the country’s income classification by the World Bank: high-, middle-, and low-income. Results: A total of 336 surveys were analyzed (response rate: 34.28%). The mean age of participants was 43.3 ± 9.8 years; 50% were male, 91% practiced in urban settings, and 18% were affiliated with academic centers. Of the participants, 76% were from middle-income countries. Nearly 80% of the participants were aware of CKM, and 65% accepted CKM as a treatment modality for kidney failure. However, only 20% consistently offered CKM to their patients and only 16% had a formal CKM program at their institution. Among these, 12% had a multidisciplinary team and only 6% had formal CKM training. The major perceived barriers to CKM implementation were financial and resource constraints (37.7% and 32.7%, respectively). Cultural and religious barriers constituted 18.3% and 8.6%, respectively, and were similar among the 3 income groups. Conclusion: Despite the significant awareness of CKM in the MENA region, its implementation remains poor. Key barriers include financial limitations, resource shortages, and a lack of training. Regional and national research is required to address these challenges and guide policies to improve CKM accessibility and implementation.http://www.sciencedirect.com/science/article/pii/S2468024925000117attitudesbarriersconservative kidney managementlow-incomeMENA |
| spellingShingle | Sahar H. Koubar Taha Hatab Farah Abdul Razzak Imed Helal Ala Ali Abdulhafid Shebani Saleh Kaysi David Gunderman Akram Al-Makki Sara N. Davison Conservative Kidney Management in the Middle East and North Africa: Attitudes, Practices, and Implementation Barriers Kidney International Reports attitudes barriers conservative kidney management low-income MENA |
| title | Conservative Kidney Management in the Middle East and North Africa: Attitudes, Practices, and Implementation Barriers |
| title_full | Conservative Kidney Management in the Middle East and North Africa: Attitudes, Practices, and Implementation Barriers |
| title_fullStr | Conservative Kidney Management in the Middle East and North Africa: Attitudes, Practices, and Implementation Barriers |
| title_full_unstemmed | Conservative Kidney Management in the Middle East and North Africa: Attitudes, Practices, and Implementation Barriers |
| title_short | Conservative Kidney Management in the Middle East and North Africa: Attitudes, Practices, and Implementation Barriers |
| title_sort | conservative kidney management in the middle east and north africa attitudes practices and implementation barriers |
| topic | attitudes barriers conservative kidney management low-income MENA |
| url | http://www.sciencedirect.com/science/article/pii/S2468024925000117 |
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