Interconnected hands from BRICS nations support a fragile kidney, symbolizing global healthcare collaboration.

Kidney Care Crisis: Unveiling Global Disparities in Renal Replacement Therapy

Reese Marlowe in Health & Wellness December 2025 • 4 min read.

"A deep dive into the inequalities of access to dialysis and transplantation in BRICS nations and what it means for global healthcare."

End-stage renal disease (ESRD) poses a significant global public health challenge, particularly in developing nations. The high costs associated with renal replacement therapy (RRT)—including hemodialysis, peritoneal dialysis, and kidney transplantation—create substantial barriers to access. This is compounded by the scarcity of resources, inadequate healthcare infrastructure, and a rising prevalence of chronic diseases.

The BRICS countries—Brazil, Russia, India, China, and South Africa—represent a unique case study. Despite their growing economic influence, these nations grapple with significant healthcare disparities. While reforms have aimed to improve equity and access, persistent inequalities remain, particularly in the availability and accessibility of RRT.

This article analyzes the multifaceted bioethical dilemmas surrounding access to RRT within the BRICS nations. By examining the disparities in treatment availability, the influence of socioeconomic factors, and the ethical considerations surrounding organ transplantation, we aim to shed light on the urgent need for equitable and sustainable solutions.

Why is Access to Kidney Treatment Unequal in BRICS Nations?

Interconnected hands from BRICS nations support a fragile kidney, symbolizing global healthcare collaboration.

A study of the inequalities in access to RRT in the BRICS countries reveals significant disparities in treatment availability. These variations stem from several factors, including economic constraints, inadequate healthcare infrastructure, and a complex interplay of bioethical considerations.

Unequal access manifests in several ways:

Limited Resources: Developing countries often face a scarcity of resources for healthcare investment, hindering the widespread availability of RRT.
Infrastructure Gaps: Inadequate healthcare infrastructure, including a shortage of dialysis centers and trained personnel, further restricts access.
Socioeconomic Factors: Poverty, social determinants, and biological vulnerabilities exacerbate the problem, creating a cycle of disadvantage.
Lack of Information: A lack of comprehensive data on dialysis and transplantation in some countries, such as India, makes it difficult to assess the true extent of the need and to implement effective interventions.

These factors contribute to a situation where many individuals in BRICS countries who require RRT are unable to receive it, leading to preventable morbidity and mortality.

What Can Be Done to Improve Access to Kidney Care?

Addressing the disparities in access to RRT requires a multifaceted approach. This includes expanding conservative treatment options, promoting local production of essential inputs, exploring non-governmental funding sources, and implementing cost-containment strategies. Furthermore, promoting deceased donor programs and fostering South-South cooperation can play a crucial role in improving access and equity. By embracing a bioethical vision that prioritizes solidarity and international cooperation, BRICS nations can work together to bridge the gap and ensure that all individuals have access to life-saving renal replacement therapy.

About this Article -

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Everything You Need To Know

What is renal replacement therapy, and why is it crucial?

End-stage renal disease (ESRD) presents a major global health problem, especially in developing countries. The high costs of renal replacement therapy (RRT), encompassing hemodialysis, peritoneal dialysis, and kidney transplantation, create significant hurdles to receiving care. Factors such as scarce resources, insufficient healthcare infrastructure, and a rising prevalence of chronic diseases further complicate this issue. The implications are severe, leading to preventable illness and death for those who cannot access treatment.

What are the key challenges in accessing kidney treatment in BRICS countries?

The BRICS countries, namely Brazil, Russia, India, China, and South Africa, face considerable healthcare inequalities despite their growing economic influence. While efforts have been made to improve equity and access, disparities persist, particularly concerning the availability and accessibility of renal replacement therapy (RRT). This means that even in nations with increasing economic strength, a significant portion of the population may not have equal opportunities to receive life-saving kidney treatments due to systemic issues within their healthcare systems.

Why is access to kidney treatment unequal in BRICS nations?

Several factors contribute to unequal access to kidney treatment within the BRICS nations. Limited resources for healthcare investment hinder the widespread availability of renal replacement therapy (RRT). Inadequate healthcare infrastructure, including a lack of dialysis centers and trained personnel, restricts access further. Socioeconomic factors, such as poverty, and biological vulnerabilities exacerbate the problem, creating a cycle of disadvantage. Moreover, a lack of comprehensive data on dialysis and transplantation in some countries makes it difficult to assess the need and implement effective interventions. These combined factors lead to situations where many individuals who require RRT are unable to receive it.

What actions can be taken to address disparities in kidney care access?

Several strategies can improve access to renal replacement therapy (RRT). Expanding conservative treatment options can provide alternatives. Promoting local production of essential inputs can reduce costs and improve availability. Exploring non-governmental funding sources can supplement government funding. Implementing cost-containment strategies can make RRT more affordable. Furthermore, promoting deceased donor programs and fostering South-South cooperation can enhance access and equity. By embracing a bioethical vision that prioritizes solidarity and international cooperation, the BRICS nations can work together to bridge the gap and ensure that all individuals have access to life-saving renal replacement therapy.

Why is it important to understand healthcare inequalities in the BRICS nations?

Renal replacement therapy (RRT) encompasses various treatments for kidney failure, including hemodialysis, peritoneal dialysis, and kidney transplantation. Hemodialysis involves filtering the blood using a machine. Peritoneal dialysis uses the lining of the abdomen to filter blood. Kidney transplantation replaces the diseased kidney with a healthy one. The choice of RRT depends on factors such as the patient's health, access to resources, and personal preferences. The ability to access these therapies is critical for individuals with end-stage renal disease (ESRD) to survive and maintain a good quality of life.