World Kidney Day 2009

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World Kidney Day is an occasion to mark growing concerns over the impact of kidney disease on global public health. Although the distribution of causes of kidney disease and access to dialysis and transplantation may vary among regions of the world, arguably, one point is universal. An expanding proportion of people in every nation in the world are affected by chronic kidney disease (CKD). In the United States, the most recent data suggest that 27 million individuals have CKD, representing nearly one in every seven adults and a 30% increase over the past decade.1 Population sampling studies from around the globe now indicate similar prevalence rates, usually ranging between 10 and 13%. Because the prevalence of CKD rises dramatically with age and is also associated with obesity and diabetes, kidney disease will be a public health concern for the foreseeable future. Kidney disease is linked with major adverse health outcomes, including premature cardiovascular disease, with a graded increase in risk as kidney function is lost.2,3 This is now clear from epidemiologic studies, community-based studies, and reanalysis of clinical trials of patients with kidney disease. The rising rate in the number of patients who do reach end-stage kidney disease and are treated with dialysis or renal transplantation also continues to be of concern. There is significant risk that the growing economic burden will render treatment costs unsustainable even in resource-rich environments. An overall decline in physical performance and cognitive function is also linked to kidney disease, markedly affecting quality of life. As a global community, we need to ask ourselves whether we have in place the strategy to address fully the universal health problems arising from kidney disease, given the biologic and culture heterogeneity of populations, diverse environments, and varying capabilities of health care delivery systems around …