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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 and Richard Yu PD Research Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
Insights
Chronic kidney disease (CKD) is a growing global health crisis. Implementing primary, secondary, and tertiary preventive measures can significantly reduce CKD
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 expenditure, with dialysis and transplantation consuming substantial portions of national budgets.
- The onset and progression of CKD are largely preventable through targeted interventions.
Purpose of the Study:
- To outline and analyze implementable measures for advancing CKD prevention globally.
- To emphasize the critical role of primary, secondary, and tertiary prevention strategies.
- To advocate for increased political and public awareness regarding CKD prevention.
Main Methods:
- Analysis of primary prevention strategies focusing on risk factor modification, structural abnormalities, and environmental exposures.
- Review of secondary prevention methods for individuals with existing kidney disease, emphasizing blood pressure and glycemic control.
- Examination of tertiary prevention in advanced CKD, focusing on managing comorbidities to delay renal replacement therapy.
Main Results:
- Primary prevention requires addressing risk factors, kidney abnormalities, and environmental nephrotoxins.
- Secondary prevention necessitates optimizing blood pressure and glycemic control in those with pre-existing kidney disease.
- Tertiary prevention involves managing comorbidities like uremia and cardiovascular disease in advanced CKD patients.
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 effective CKD screening, management, and treatment.
- Raising 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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