The Nexus of Acute Kidney Injury, Chronic Kidney Disease, and World Kidney Day 2009

Abstract

Acute kidney injury (AKI) is a devastating disease that affects patients throughout the world and is associated with high morbidity and mortality. It has been traditionally thought that patients who do survive recover renal function; however, recent population-based evidence strongly suggests that this may not be the case in many instances. New data suggest that a strikingly large percentage of patients who have AKI require permanent renal replacement therapy or do not fully recover renal function, and that this population has an important and growing impact on the global epidemiology of chronic kidney disease (CKD) and end-stage renal disease (ESRD). World Kidney Day is a campaign to increase global health awareness of the importance of CKD. This campaign, representing a joint initiative of the International Society of Nephrology (ISN) and the International Federation of Kidney Foundations (IFKF) will be held on March 12, 2009 and will be celebrated in more than 100 countries and on six continents. The impetus for this campaign is to increase public awareness of the burgeoning impact of CKD and ESRD to global health. By some estimates based on the Kidney Disease Outcome Quality Initiative (K/DOQI)-defined stage 1 to 4, approximately 13% of the world population may have CKD (1,2). Current estimates suggest that 1.6 million individuals worldwide undergo maintenance dialysis; however, many developing countries remain without adequate access to renal replacement therapy (3). In the United States, 0.5 million patients were treated for ESRD (with dialysis or kidney transplantation) in 2005, a number which is projected to increase to 0.7 million by 2015 (4). Although nephrologists collectively expend considerable effort attempting to attenuate the progression of CKD with a variety of therapeutic strategies, only a small fraction of patients with CKD progress to ESRD because death from other causes, including cardiovascular disease, is …