World Kidney Day - Early Detection and Prevention | Western Cape Government

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World Kidney Day - Early Detection and Prevention

8 March 2006
FACT - chronic kidney disease and other major chronic non-communicable diseases will claim the lives of 36 million people by the year 2015.

The International Society of Nephrology (ISN) and the International Federation of Kidney (IFKF) established that the only response to this global crisis is early detection and prevention. As an immediate response to this alarming prospect, the ISN and IFKF jointly announced the launch of an annual World Kidney Day (WKD) to be held on the second Thursday of March, starting with Thursday March 9, 2006.

"Chronic kidney disease (CKD) is a major health problem in Southern Africa with many people affected by kidney problems," said Pierre Uys, Minister of Health for the Western Cape. It is reported that CKD may be present in more than 10% of adult population.

"This is specifically related to the increased incidence of diabetes and hypertension amongst the South African population," said Prof. Mignon McCulloch, South African Renal Society. The main aim WKD would be to foster awareness of prevention and screening programs of people in 'high-risk groups'.

"The key objectives of a World Kidney Day 2006 represents the first vital step in achieving two main long-term goals," said Uys. He added that these goals are to "increase awareness of chronic kidney disease and its associated cardiovascular morbidity and mortality and also to draw attention to the urgent global need for early detection and prevention" of chronic kidney disease.

Early detection can be accomplished through systematic testing for serum creatinine or urine albumin - particularly in high-risk individuals such as those over 50 or in individuals who are obese; who smoke; who have diabetes (or a history of diabetes in the family) or have hypertension.

The principal focus of WKD 2006 is to firstly target general physicians and primary healthcare professionals to raise their awareness of both the role of the kidney as a risk marker in related chronic diseases and the pressing need for early detection of any form of kidney impairment.

Released by:
The Western Cape Provincial Department of Health
Contact person: Mark van der Heever
Tel: 021 483 3716

FACT SHEET

Why a World Kidney Day, Why Early Detection and Prevention?

Chronic non-communicable diseases (particularly cardiovascular disease, hypertension, diabetes mellitus and chronic kidney disease) have now replaced the communicable diseases as the leading threat to public health and health budgets worldwide.

Deaths claimed by infectious diseases will decline by 3% over the next decade. In marked contrast, chronic diseases - that already account for 72% of the total global burden of disease in people over 30 - will increase by 17%. Much of this in developing countries.

The cost of treating these chronic diseases, already 80% of many health care budgets, represents a leading threat to public health and healthcare resources worldwide.

The only feasible global response to this pending health and socio-economic crisis is chronic disease prevention.

Early Detection and Prevention - World Kidney Day 2006

CKD if detected early can be treated, thereby reducing other complications.

The role of the kidney

  • The kidney, too often overlooked as part of global public health efforts, has now emerged as central to prevention efforts.
  • The cost of renal replacement therapy (RRT) for total kidney failure weighs heavy on many health care budgets.
  • Even more importantly, kidney disease is a "disease multiplier". It causes death in many people with diabetes and hypertension and predicts the development of a cardiovascular event.

Abnormalities in kidney function often represent an early window into the state of the general vascular system. This window facilitates early disease detection before patients develop the more devastating problems such as stroke, peripheral vascular disease, coronary heart disease and kidney failure.

This new information now demands that the kidney assumes a central role in global health and prevention efforts because increased awareness of kidney disease has the immediate potential to dramatically reduce the growing burden of deaths and disability from chronic cardiovascular disease worldwide.

World Kidney Day - March 9, 2006 and beyond.

Promoting early detection and prevention represents the first step towards achieving the World Health Organization (WHO) recommended global goal of reducing chronic disease related death rates by 2% per year over the next decade.

Chronic kidney diseases and vascular diseases will kill 36 million people by the year 2015.

What is Chronic Kidney Disease (CKD)?
  • FACT: CKD is present when individuals have an increase in excretion of albumin in the urine or a major decrease in kidney function or glomerular filtration rate (GFR). This may lead to complications such as high blood pressure, anaemia, and heart and blood vessel disease.

How common is chronic kidney disease?
  • FACT: Globally more than 500 million individuals, or about one person in ten in the general population, have some degree of chronic kidney disease.
What causes chronic kidney disease?
  • FACT: Globally the most common causes of CKD have been nephrotic or inflammatory diseases of the kidney, infections, obstruction in the urinary tract and inherited disorders like polycystic kidney disease. This is changing in both developed and developing nations towards diabetes and hypertension, which are also the most common causes of cardiovascular disease (CVD).
How is chronic kidney disease detected?
  • FACT: Simple laboratory tests are done on small samples of blood and urine to measure creatinine content and calculated GFR and albumin excretion.
What are the consequences of undetected chronic kidney disease?
  • FACT: The first consequence is the risk of developing progressive loss of kidney function leading to kidney failure and the need for dialysis or transplantation. The second is premature death from associated cardiovascular disease.
  • FACT: Individuals who appear to be healthy who are then found to have CKD have at least a tenfold risk of dying prematurely from CVD (coronary disease, cerebrovascular disease, peripheral artery disease, and heart failure) regardless of whether they develop kidney failure. CKD contributes towards morbidity from CVD in over 12 million individuals worldwide each year. These numbers are rapidly rising due to the global epidemic of type 2 diabetes.
What are the costs and consequences to society of the growing epidemic of CKD?
  • FACT: The costs of end-stage renal disease are escalating. Worldwide, over 1.5 million people are currently alive through either hemo or peritoneal dialysis or transplantation. The number is forecasted to double within the next decade. The cumulative global cost for dialysis and transplantation over the next decade is predicted to exceed US$ 1 trillion. This economic burden could strain healthcare budgets in developed countries. For lower income countries it is impossible to meet such costs.
  • FACT: More than 80% of individuals receiving renal replacement therapy (RRT) live in the developed world because in developing countries it is largely unaffordable. In countries such as India and Pakistan less than 10% of all patients who need it receive any kind of renal replacement therapy. In many African countries there is little or no access to RRT, meaning many people simply die.
  • FACT: The economic burden for developing countries is particularly severe, partly because CKD generally occurs at a younger age. For example, in Guatemala, 40% of patients on RRT are under 40. In China, the economy will lose US$558 billion over the next decade due to effects on death and disability attributable to chronic cardiovascular and renal disease.
What can be done to detect, prevent and treat chronic kidney and cardiovascular disease?

Detection

  • FACT: Simple tests are now available for serum creatinine, calculated GFR and urine albumin that allow early detection of CKD.
  • FACT: The majority of individuals with early stages of CKD go undiagnosed, particularly in the developing world. The early detection of kidney impairment is essential and allows suitable treatment before kidney damage or deterioration manifests itself through other complications.

Prevention and delay

  • FACT: Screening must be high priority in subjects considered to be at high risk of kidney disease, namely:
    • Patients with diabetes mellitus and hypertension.
    • Individuals who are obese or smoke.
    • Individuals over 50 years of age.
    • Individuals with a family history diabetes mellitus, hypertension and kidney disease.
    • Patients with a presence of other kidney diseases.
  • FACT: Current kidney protective treatments should now be extended to those with early stages of renal failure.
  • FACT: Key preventative measures have been defined and proven successful in protecting against both renal and cardiovascular disease, such as:
    • ACEs/ARBs for proteinuria and decreased GFR.
    • Reduction of high blood pressure -the lower the blood pressure, the lower the GFR decline.
    • Control of glucose, blood lipids and anemia.
    • Smoking cessation.
    • Increased physical activity.
    • Control of body weight .
    • Treatment
  • FACT: Clinical research over the last decade has shown the potential of blockade of the renin-angiotensin system by ACEs and ARBs to reduce the burden of disease from CVD, diabetes, hypertension and CKD significantly and at relatively low cost. ACE inhibitors are effective in preventing progressive renal function decline. Angiotensin-II-antagonists lower albuminuria and prevent progressive renal failure.
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