A time to act for prevention

Abstract

The Hong Kong Society of Nephrology successfully hosted the International Society of Nephrology (ISN) 2004 Conference on Prevention of Progression of Renal Disease from 29 June to 1 July 2004, the first ISN thematic conference on prevention held in collaboration with the ISN. Well over 1250 nephrologists, general physicians, primary care doctors, health care administrators, scientists, laboratory workers, trainees, renal nurses, and our industrial partners from 39 countries attended the conference, making it the largest prevention meeting in the recorded history of both societies. In 2003, Asia and many parts of the world saw an unprecedented challenge for the medical profession of this generation. SARS hit the world hard with serious sequelae on our community, as well as the profession. This meeting was postponed as a result. Thereafter, Hong Kong, like many other countries, focused a lot of attention and, obviously, resources, on communicable and infectious diseases. However, the noncommunicable diseases have not decreased in magnitude and severity. The incidence of end-stage renal failure requiring replacement therapy has increased significantly around the world, and the annual incidence has increased to 140 new cases per million population in Hong Kong, with a total of 6000 uremic patients requiring treatment1.Hong Kong Renal Registry Data Time to act for prevention.2004Google Scholar. Nephrologists around the world are fighting hard to find ways to prevent this problem because there are few countries, be it developing or developed, that can afford such treatment in 10 to 20 years' time, not to mention the immense human suffering from the disease. There were about 1.5 million patients on dialysis in the year 2000, and by 2010, this number is projected to increase to 2.5 million, a 7% increase each year2.Lysaght M.J. Maintenance dialysis population dynamics: Current trends and long-term implications.J Am Soc Nephrol. 2002; 13: S37-40https://doi.org/10.1159/000049148Crossref PubMed Scopus (41) Google Scholar. Hong Kong is seeing similar trend. The predicted dialysis cost globally will increase to about US $ 1.1 trillion for the decade 2001 to 2010 compared with about US$ 500 billion spent for the last decade worldwide2.Lysaght M.J. Maintenance dialysis population dynamics: Current trends and long-term implications.J Am Soc Nephrol. 2002; 13: S37-40https://doi.org/10.1159/000049148Crossref PubMed Scopus (41) Google Scholar. The World Health Organization has already recognized that renal disease is a public health issue. Diabetes and glomerulonephritis are the two most common causes for the new cases of renal failure. Yet, we still have 25% of patients coming to us in Hong Kong without a definite diagnosis of the underlying renal problem because they presented too late. The Hong Kong Society of Nephrology recently conducted a screening program named SHARE, that is, the Screening of Hong Kong Asymptomatic Renal Population and Evaluation. In short, about 10% from ages 21 to 40, 24% from 41 to 60, and 33% from individuals over age 60 who are apparently healthy are found to have either high blood pressure or asymptomatic urinary abnormalities, which are the risk factors for developing renal disease3.Li P.K. Kwan B.C. Leung C.B. For The Hong Kong Society Of Nephrology et al.Prevalence of silent kidney disease in Hong Kong: The Screening for Hong Kong Asymptomatic Renal Population and Evaluation (SHARE) program.Kidney Int. 2005; 67: S36-40Abstract Full Text Full Text PDF Google Scholar. This speaks out well that we need more public awareness on early detection and treatment, as well as the awareness from the family physicians and general physicians. The Conference began with a Consensus Workshop, which set the floor for invited specialists from around the world to discuss global prevention of chronic kidney diseases. The result is now provided as a consensus statement and published in this supplement toKidney International, acting as a framework for clinical practice guidance, implementation of public health policy, and for further studies. For our extensive Scientific Program, many of the outstanding speakers delivered their interesting presentations on their specialized areas in screening and prevention program, basic research, genetics, diabetic nephropathy, glomerular disease, hypertension, and cardiovascular diseases, as well as treatment. Almost all of their presentations are now compiled in this issue by the leading authority in the field, and we hope this can act as a good resource for both the developed and developing world in their act of building programs for fighting this important disease.