Mind the gap in kidney care: Translating what we know into what we do
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Published on: April 12, 2021
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, 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
It takes too long to implement new kidney disease treatments. Early diagnosis and treatment of kidney disease and its risk factors like hypertension and diabetes are crucial but often delayed due to numerous barriers.
Area of Science:
- Nephrology
- Public Health
- Health Services Research
Background:
- Significant delays exist in translating kidney disease treatments from clinical evidence to practice.
- Effective interventions for preventing and delaying kidney disease are underutilized.
- Many individuals with kidney disease risk factors (hypertension, diabetes) and kidney disease itself remain undiagnosed or undertreated.
Purpose of the Study:
- To highlight the critical need to accelerate the implementation of evidence-based kidney disease treatments.
- To identify barriers hindering early diagnosis and appropriate management of kidney disease.
- To advocate for maximizing opportunities for early kidney disease detection and treatment, particularly at the primary care level.
Main Methods:
- This is a conceptual and evidence-based review, not a primary research study.
- Analysis of existing literature and guidelines on kidney disease prevention and management.
- Identification and categorization of barriers to care across patient, clinician, health system, and societal levels.
Main Results:
- A substantial gap persists between established knowledge and clinical practice in kidney disease care.
- Early stages of kidney disease are often asymptomatic, leading to delayed diagnosis.
- Numerous systematic barriers impede timely and effective kidney disease diagnosis and treatment.
Conclusions:
- Urgent action is required to reduce the 17-year average delay in implementing kidney disease treatments.
- Addressing barriers at all levels is imperative for preserving and improving global kidney health.
- Early intervention, starting in primary care, is essential to prevent severe outcomes like kidney failure and death.
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