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Mind the Gap in Kidney Care: Translating What We Know Into What We do
Valerie A Luyckx1,2,3, Katherine R Tuttle4,5, Dina Abdellatif6
1Department of Public and Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland.
Abstract:
Historically, it takes an average of 17 years to move new treatments from clinical evidence to daily practice. Given the highly effective treatments now available to prevent or delay kidney disease onset and progression, this is far too long. The time is now to narrow the gap between what we know and what we do. Clear guidelines exist for the prevention and management of common risk factors for kidney disease, such as hypertension and diabetes, but only a fraction of people with these conditions worldwide are diagnosed, and even fewer are treated to target. Similarly, the vast majority of people living with kidney disease are unaware of their condition, because in the early stages, it is often silent. Even among patients who have been diagnosed, many do not receive appropriate treatment for kidney disease. Considering the serious consequences of kidney disease progression, kidney failure, or death, it is imperative that treatments are initiated early and appropriately. Opportunities to diagnose and treat kidney disease early must be maximized beginning at the primary-care level. Many systematic barriers exist, ranging from patient to clinician to health systems to societal factors. To preserve and improve kidney health for everyone everywhere, each of these barriers must be acknowledged so that sustainable solutions are developed and implemented without further delay.
Insights
Accelerating the adoption of effective kidney disease treatments is crucial. Bridging the gap between medical knowledge and patient care requires addressing diagnostic and treatment barriers at all levels.
Area of Science:
- Nephrology
- Public Health
- Health Services Research
Background:
- Significant delays exist in translating kidney disease research into clinical practice, hindering patient outcomes.
- Effective treatments are available to prevent or slow kidney disease, yet their implementation lags considerably.
- Many individuals with risk factors like hypertension and diabetes, or even diagnosed kidney disease, remain undiagnosed or undertreated.
Discussion:
- Kidney disease often progresses silently in early stages, leading to widespread lack of awareness and delayed diagnosis.
- Despite existing guidelines, a substantial gap persists between recommended and actual patient care for kidney disease.
- Systematic barriers at patient, clinician, health system, and societal levels impede timely diagnosis and treatment.
Key Insights:
- Early diagnosis and intervention are critical to prevent severe kidney disease complications, including kidney failure and mortality.
- Primary care settings represent a key opportunity for maximizing early kidney disease detection and treatment initiation.
- Addressing multifaceted barriers is essential for improving kidney health globally.
Outlook:
- Developing and implementing sustainable solutions to overcome identified barriers is imperative.
- Urgent action is needed to narrow the gap between current knowledge and clinical practice in kidney disease management.
- A concerted effort is required to preserve and improve kidney health for all populations worldwide.
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