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Challenges and opportunities in late-stage chronic kidney disease
Steven Fishbane1, Azzour D Hazzan1, Candice Halinski1
1Department of Medicine, Division of Nephrology, Hofstra North Shore LIJ School of Medicine , Great Neck, NY , USA.
Insights
Chronic kidney disease (CKD) is a costly, prevalent condition. Recognizing late-stage CKD as distinct from early stages is crucial for appropriate funding and improved patient care.
Area of Science:
- Nephrology
- Public Health
- Health Economics
Background:
- Chronic diseases pose significant challenges to healthcare systems and economies.
- Chronic kidney disease (CKD) is highly prevalent and costly, yet receives less attention than other chronic conditions.
- Aging populations are expected to increase the incidence and cost of chronic diseases, including CKD.
Purpose of the Study:
- To review the burden of chronic diseases and challenges in CKD care.
- To propose strategies for improving late-stage CKD management.
- To advocate for reclassifying late-stage CKD as distinct from earlier stages for better recognition and funding.
Main Methods:
- Literature review on chronic disease burden and CKD.
- Analysis of challenges and barriers in current CKD care pathways.
- Development of recommendations for enhancing late-stage CKD management.
Main Results:
- Late-stage CKD is as complex and costly as other major chronic diseases.
- Current healthcare systems may underfund CKD due to a lack of distinction between early and late stages.
- Improved care requires better continuity, IT integration, multidisciplinary approaches, timely nephrology referral, protocols, and patient engagement.
Conclusions:
- Defining late-stage CKD distinctly is essential for appropriate health authority recognition and funding.
- Implementing proposed strategies can significantly improve the quality and efficiency of late-stage CKD care.
- Enhanced patient engagement and multidisciplinary care are key to managing this complex condition.
Abstract:
There is increasing recognition that chronic diseases are a major challenge for health delivery systems and treasuries. These are highly prevalent and costly diseases and frequency is expected to increase greatly as the population of many countries ages. Chronic kidney disease (CKD) has not received the same attention as other chronic diseases such as congestive heart failure; yet, the prevalence and costs of CKD are substantial. Greater recognition and support for CKD may require that the disease no longer be viewed as one continuous disease state. Early CKD stages require less complex care and generate lower costs. In contrast, late-stage CKD is every bit as complex and costly as other major chronic diseases. Health authorities may not recognize and fund CKD care appropriately until late-stage CKD is defined clearly as separate and distinct from earlier stages of disease. In this review, we describe the burden of chronic diseases, consider the challenges and barriers and propose processes to improve late-stage CKD care. In particular, we recommend the need for improved continuity of care, enhanced use of information technology, multidisciplinary care, timely referral to nephrologists, protocol use and improved patient engagement.
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