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Kidney health for everyone everywhere - from prevention to detection and equitable access to care
Insights
Chronic kidney disease (CKD) is a growing global health threat and a major cause of healthcare costs. Preventive strategies, including risk factor modification and early intervention, are crucial for managing CKD progression and reducing its impact.
Area of Science:
- Nephrology
- Public Health
- Preventive Medicine
Background:
- Chronic kidney disease (CKD) presents a rapidly increasing global health burden, projected to be the 5th leading cause of years of life lost by 2040.
- CKD significantly contributes to catastrophic health expenditures, with dialysis and transplantation consuming substantial healthcare budgets.
- The onset and progression of CKD are often preventable, necessitating a focus on effective interventions.
Purpose of the Study:
- To outline and analyze implementable measures for promoting and advancing CKD prevention globally.
- To emphasize the importance of primary, secondary, and tertiary preventive interventions for kidney disease.
Main Methods:
- Review of primary prevention strategies focusing on risk factor modification, addressing structural abnormalities, and mitigating environmental exposures and nephrotoxins.
- Analysis of secondary prevention in individuals with pre-existing kidney disease, emphasizing blood pressure and glycemic control.
- Evaluation of tertiary prevention in advanced CKD patients, focusing on managing co-morbidities to delay or avoid renal replacement therapy.
Main Results:
- Primary prevention requires addressing modifiable risk factors and environmental exposures.
- Secondary prevention hinges on optimizing blood pressure and glycemic control in individuals with existing kidney disease.
- Tertiary prevention involves managing co-morbidities like uremia and cardiovascular disease in advanced CKD.
Conclusions:
- A comprehensive, multi-level preventive approach is essential for combating the rising burden of CKD.
- Political will and specific national policies are crucial for enhancing CKD screening, management, and treatment awareness.
- Increased awareness among the public, healthcare professionals, and policymakers is urgently needed to promote preventive measures.
Abstract:
The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual healthcare budget in high-income countries. Crucially, however, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions - be it primary, secondary or tertiary. This complementing article focuses on outlining and analyzing measures that can be implemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, management of co-morbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to proliferate the preventive approach. While national policies and strategies for non-communicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management, and treatment are often lacking. Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals, and policy makers.
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