population) ®Number of community health workers (per 10,000 population) ®Number of nurses (per 10,000 population) ®Regional distribution ®Nephrology trainees/graduates per year ®Availability of multidisciplinary teams ®Literature reviews ®Surveys ®Interviews ®WHO Global Observatory ®Professionals (GPs, nephrologists, diabetologists, endocrinologists, cardiologists, other related disciplines): total and as a ratio to whole population/ or dialysis population ®Financial resources, remuneration and incentives (including those for GPs/specialists to identify and manage CKD patients) ®Presence of other credentialed health care providers (e.g., nephrology nurses, dieticians) Health information systems ®CKD (non-dialysis) registry ®KRT registry ®Literature reviews ®Surveys ®Interviews ®Reach ®Scope Essential medicines and technologies ®ACEi/ARBs ®Statins ®Aspirin ®Other blood pressure medications ®Anemia medications (EPO/iron) ®CKD-MBD (calcium binders, renagel, cinacalcet) ®Specific (GN and transplant) ®Dialysis availability, access and coverage ®Transplant availability, access and coverage ®Literature reviews ®Surveys ®Interviews ®WHO Global Observatory (for some essential medicines) ®Access to medications that manage risk factors to prevent the development or progression of AKI or CKD Health financing ®Total expenditure for CKD and ESKD ®Public and private contributions ®Out-of-pocket payments for essential medicines ®Out-of-pocket payments for non-dialysis CKD care ®Out-of-pocket payments for dialysis ®Out-of-pocket payments for transplant ®Literature reviews ®Surveys ®Interviews ®WHO Global Observatory ®Fund medications to prevent the development or progression of AKI or CKD Leadership and governance (national policies and frameworks) ®Guidelines/frameworks on CKD and ESKD care ®Advocacy efforts and initiatives ®Early detection and prevention programs ®eGFR reporting ®Literature reviews ®Surveys ®Interviews ®WHO Global Observatory ®WHO NCD Strategy ®Availability, awareness, and adoption of policies and guidelines targeted toward kidney care ISN Global Kidney Health Atlas | 2019 Methods | 31 3. A scoping review of KRT cost estimates across countries and regions, including: ® Cost of maintenance HD; ® Cost of maintenance PD; ® Cost of kidney transplantation (the first year); and ® Cost ratio of maintenance HD to maintenance PD. 2.3.1 Scoping review of health system characteristics The objective of the broad review was to obtain a snapshot of individual country and regional health system characteristics and specific elements relevant to ESKD care, focused on the general WHO UHC domains (Table 2.1) and specific domains related to kidney disease (Table 2.2). The comprehensive search strategy was developed in conjunction with an expert medical librarian. Data sources included: ® Data and reports published by the WHO Global Observatory, UN, World Bank, and OECD; ® Both published and unpublished documents from international organizations/bodies (i.e., OECD, WHO, UN, Commonwealth Fund, World Bank, EU and its affiliates, etc.), and reports published by national governments (and occasionally regional governments within countries) on the organization and delivery of ESKD care; and ® Additional literature identified by key stakeholders (i.e., opinion leaders, national nephrology society leaders, ISN leaders) and through consultation with national nephrology societies and ISN regional boards. 2.3.2 Systematic review of relevant ESKD epidemiological data The objective of the systematic review was to collect epidemiological data on the incidence and prevalence of KRT. Health system features across countries and regions with implications for ESKD care were also reviewed. Data on key estimates of KRT were defined by the incidence and prevalence of ESKD (overall) and by different dialysis modalities (HD and PD) and kidney transplantation. These data were extracted from key reports, including annual reports of the ESKD renal registries and databases such as the Global Observatory on Donation and Transplantation (GODT), as well as identified relevant published and gray literature. Data sources included: ® Statistics/published reports from national and regional government agencies (where available) identified during our gray literature search and by experts; ® Reports published by international organizations (WHO, World Bank, UN, and OECD), including world health statistics and health system reports; ® Leaders of national and regional nephrology associations and key opinion leaders who helped us gather data relevant to all aspects of the inventory; ® Published scientific literature on the various aspects of KRT epidemiology, economics, and organization of care according to standard guidelines63,64 which, as in our previous work, provided additional complementary data for the atlas;65,66 ® A gray literature search based on a strategy developed with assistance from an expert research librarian and tailored to the six UHC domains and the taxonomy developed by the WHO; and ® Renal registries that collect data on patients with ESKD who receive KRT, which were identified through a rapid review of publications and annual reports produced by governments and renal professional associations (Table 2.3). 32 | Methods ISN Global