Related Experiment Video
Updated: Jun 7, 2025
Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
Published on: April 12, 2021
Mind the gap in kidney care: Translating what we know into what we do
Valerie A Luyckx1, Katherine R Tuttle2, Dina Abdellatif3
1Department of Public and Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland; Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.
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, despite existing guidelines for risk factors like hypertension and diabetes, are significantly delayed due to numerous barriers.
Area of Science:
- Nephrology
- Public Health
- Healthcare Management
Background:
- Significant delay exists in translating kidney disease treatments from clinical evidence to practice.
- Effective interventions to prevent or slow kidney disease are underutilized.
- Many individuals with risk factors (hypertension, diabetes) or 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 and address systemic barriers hindering early diagnosis and appropriate management of kidney disease.
- To emphasize the importance of primary care in maximizing opportunities for early kidney disease intervention.
Main Methods:
- The study reviews existing guidelines for managing common kidney disease risk factors.
- It analyzes the current state of diagnosis and treatment for kidney disease globally.
- Barriers to care are examined across patient, clinician, health system, and societal levels.
Main Results:
- A substantial gap persists between established kidney disease knowledge and clinical practice.
- Early stages of kidney disease are often asymptomatic, leading to delayed diagnosis.
- Despite available treatments, a small fraction of at-risk individuals receive timely diagnosis and optimal care.
Conclusions:
- Urgent action is required to narrow the gap between kidney disease knowledge and practice.
- Overcoming systematic barriers at all levels is essential for improving kidney health outcomes.
- Maximizing early diagnosis and treatment, particularly at the primary care level, is imperative to prevent severe consequences.
Related Concept Videos
01:27Dialysis
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
01:12Internal Anatomy of the Kidney
Anatomical Position and Dimensions
The kidneys are retroperitoneal organs positioned against the posterior abdominal wall on either side of the spine, roughly between the twelfth thoracic and third lumbar vertebrae. Each kidney is typically 10-12 cm long, 5-6 cm wide, and 3-4 cm thick, weighing about 150 grams.
Renal Cortex
The outermost region of the kidney is the...
01:28Renal Drug Excretion: Tubular Secretion