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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, Hirschengraben 84, 8001, 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
Bridging the gap between kidney disease knowledge and practice is crucial. Early diagnosis and treatment of kidney disease, hypertension, and diabetes are essential to prevent severe outcomes and improve global kidney health.
Area of Science:
- Nephrology
- Public Health
- Health Systems Research
Background:
- Significant delay exists in translating kidney disease treatments from evidence to practice.
- Effective interventions for preventing and delaying kidney disease are underutilized.
- Many individuals with risk factors like hypertension and diabetes, and even those with kidney disease, remain undiagnosed or undertreated.
Purpose of the Study:
- To highlight the critical need to accelerate the implementation of evidence-based kidney disease treatments.
- To emphasize the importance of early diagnosis and management of kidney disease and its risk factors.
- To identify and address barriers hindering timely and appropriate kidney disease care.
Main Methods:
- The study reviews existing guidelines for managing hypertension and diabetes as kidney disease risk factors.
- It analyzes the current state of kidney disease diagnosis and treatment rates globally.
- It identifies systemic barriers across patient, clinician, health system, and societal levels.
Main Results:
- A substantial gap persists between available kidney disease knowledge and its clinical application.
- Early stages of kidney disease are often asymptomatic, leading to delayed diagnosis.
- Inequitable access to diagnosis and appropriate treatment for kidney disease and its risk factors is widespread.
Conclusions:
- Urgent action is required to reduce the 17-year average delay in implementing new kidney disease treatments.
- Maximizing opportunities for early kidney disease detection and intervention, particularly at the primary care level, is imperative.
- Overcoming multifaceted barriers is essential for preserving and improving kidney health worldwide.
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