Abstract
The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual healthcare budget in high-income countries. Crucially, however, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions – be it primary, secondary or tertiary. This complementing article focuses on outlining and analyzing measures that can beimplemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, management of co-morbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to proliferate the preventive approach. While national policies and strategies for non-communicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management and treatment are often lacking. Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals and policy makers.
Highlights
Around 850 million people currently are affected by different types of kidney disorders.[1]
The global burden of chronic kidney disease (CKD) is increasing, and CKD is projected to become the 5th most common cause of years of life lost globally by 2040.[2]. If CKD remains uncontrolled and if the affected person survives the ravages of cardiovascular and other complications of the disease, CKD progresses to end-stage renal disease (ESRD), where life cannot be sustained without dialysis therapy or kidney transplantation
As the Sustainable Development Goals (SDG) and Universal Health Coverage (UHC) agendas progress and provide a platform for raising awareness of NCD health care and monitoring needs, targeted action on kidney disease prevention should become integral to the global policy response.[1]
Summary
Around 850 million people currently are affected by different types of kidney disorders.[1]. According to the expert definitions including the Center for Disease Control and Prevention,[11] the term “prevention” refers to activities that are typically categorized by the following three definitions: (1) Primary Prevention, implies intervening before health effects occur in an effort to prevent the onset of illness or injury before the disease process begins (2) Secondary Prevention suggests preventive measures that lead to early diagnosis and prompt treatment of a disease to prevent more severe problems developing and includes screening to identify diseases in the earliest stages, and (3) Tertiary Prevention indicates managing disease after it is well established in order to control disease progression and the emergence of more severe complications, which is often by means of targeted measures such as pharmacotherapy, rehabilitation, and screening for and management of complications These definitions have important bearing in the prevention and management of the chronic kidney disease (CKD), and accurate identification of risk factors that cause CKD or lead to faster progression to renal failure as shown in Figure 1 are relevant in health policy decisions and health education and awareness related to CKD.[12]. The incidence of CKD, rate of progression, and effectiveness of drug therapy were major drivers of cost-effectiveness and CKD screening may be more cost-effective in populations with higher incidences of CKD, rapid rates of progression, and more effective drug therapy
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