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Kidney Health for Everyone Everywhere - From prevention to detection and equitable access to care
Philip Kam-Tao Li1, Guillermo Garcia-Garcia2, Siu-Fai Lui3
1Department of Medicine and Therapeutics, Carol & Richard Yu PD Research Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong.
Insights
Chronic kidney disease (CKD) is a growing global health threat and a significant financial burden. Early and consistent preventive measures, including risk factor modification and political will, are crucial for managing and delaying its progression.
Area of Science:
- Nephrology
- Public Health
- Preventive Medicine
Background:
- Chronic kidney disease (CKD) presents a rapidly escalating global health challenge, projected to be the fifth leading cause of lost life years by 2040.
- CKD significantly contributes to healthcare costs, with dialysis and transplantation consuming substantial portions of national budgets in high-income nations.
- The onset and progression of CKD are largely preventable, underscoring the need for 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 health.
- To advocate for increased political and public awareness regarding CKD prevention strategies.
Main Methods:
- Reviewing and analyzing primary prevention strategies focusing on risk factor modification, structural abnormalities, environmental exposures, and nephrotoxins.
- Examining secondary prevention approaches for individuals with existing kidney disease, emphasizing blood pressure and glycemic control.
- Assessing tertiary prevention measures for advanced CKD patients, including co-morbidity management to delay renal replacement therapy.
Main Results:
- Primary prevention requires addressing modifiable risk factors and environmental/nephrotoxic exposures.
- Secondary prevention in pre-existing CKD necessitates rigorous blood pressure and glucose management.
- Tertiary prevention in advanced CKD focuses on managing co-morbidities like uremia and cardiovascular disease to postpone dialysis or transplantation.
Conclusions:
- A comprehensive, multi-level preventive approach is essential for combating the rising burden of CKD.
- Political commitment and specific national policies for CKD education, screening, and management are urgently needed.
- Raising awareness among the public, healthcare professionals, and policymakers is critical for advancing CKD prevention efforts.
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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