Chronic Kidney Disease: A Neglected Global Health Crisis Demanding Urgent Action from the WHO

Core Concepts

Chronic kidney disease (CKD) is a major global health threat that has been overlooked by the World Health Organization (WHO) in its list of priority noncommunicable diseases (NCDs), despite its significant contribution to premature mortality and disability worldwide.

Abstract

The content discusses a joint statement issued by three major international nephrology societies - the International Society of Nephrology, the European Renal Association, and the American Society of Nephrology - calling on the WHO to recognize CKD as a major NCD public health priority. The key points are: In 2015, the UN set a Sustainable Development Goal of reducing premature mortality from NCDs by a third by 2030, but the WHO's list of major NCD drivers did not include CKD, which was an oversight. Global mortality from all kidney diseases likely ranges between 5-11 million per year, and kidney dysfunction is the 7th leading risk factor for death globally. Failure to include CKD in the WHO's NCD priorities misses the opportunity to address a major contributor to premature and preventable mortality. The global burden of kidney disease is expected to become the 5th most common NCD driver of mortality by 2040. In addition to increasing premature mortality, CKD also promotes morbidity, disability, reduced quality of life, and has significant economic and environmental impacts. The statement calls for measures to improve access to kidney care, adopt a staged approach to understanding and responding to CKD, task-share preventive and management interventions, utilize technological solutions, integrate primary and specialist care, and involve patients and communities. Recognizing CKD as a major NCD priority by the WHO could raise global awareness, guide the development of CKD guidelines and standards, and improve surveillance and resource allocation.

Stats

Global mortality from all kidney diseases likely ranges between 5 million and 11 million per year. Kidney dysfunction is currently the seventh leading risk factor for death globally. The global burden of kidney disease is expected to become the fifth most common NCD driver of mortality by 2040. Approximately 2%-4% of the healthcare budget in many high-income countries is spent on the 0.1%-0.2% of the population with kidney failure.

Quotes

"Failure to include kidney disease in this initiative misses the opportunity to address a major contributor to premature and preventable mortality. Changing population dynamics and evolving risk accumulation mean that the global burden of kidney disease is increasing relentlessly to become the fifth most common NCD driver of mortality by 2040." "despite kidney disease being common, deadly and costly, public awareness of it remains low. This lack of awareness reflects a failure of global public health agendas to adequately acknowledge the burden of kidney disease and undermines efforts to mitigate risk factors and improve early diagnosis."

Key Insights Distilled From

Groups Ask WHO to Recognize Chronic Kidney Disease Threat

by Miriam E. Tu... at www.medscape.com 04-05-2024

https://www.medscape.com/viewarticle/groups-ask-who-recognize-chronic-kidney-disease-threat-2024a10006hl

Deeper Inquiries

How can the WHO effectively integrate CKD prevention and management strategies into its existing NCD framework and global health initiatives?

To effectively integrate CKD prevention and management strategies into its existing NCD framework and global health initiatives, the WHO can start by recognizing CKD as a major NCD driver of premature mortality. This recognition would raise awareness and prioritize CKD within the global health agenda. The WHO should work on developing CKD guidelines and standards of care, evidence-based prevention approaches, and new therapies. By including CKD in its initiatives, the WHO can improve surveillance, allocate resources more efficiently, and enhance global awareness of the disease.

What are the potential barriers and challenges in raising awareness and prioritizing CKD as a major NCD threat, and how can they be overcome?

One potential barrier to raising awareness and prioritizing CKD as a major NCD threat is the lack of public awareness about the disease. This can be overcome by implementing educational campaigns to inform the public about the impact of CKD on premature mortality and quality of life. Another challenge is the financial burden of kidney disease, especially in resource-limited settings. To address this, strategies such as task-sharing interventions with nonspecialized workers, adopting technological solutions for early detection, and integrating primary preventive care with specialist care can help overcome these challenges.

What innovative approaches and technologies could be leveraged to improve early detection, risk stratification, and community-based management of CKD, especially in resource-limited settings?

Innovative approaches and technologies that could be leveraged to improve early detection, risk stratification, and community-based management of CKD in resource-limited settings include the use of digital platforms and point-of-care tests for easier and quicker diagnosis. Implementing community-based interventions to enhance preventive care and integrating kidney care services into routine primary care can also improve management. Additionally, involving patients and family members in planning and providing services can enhance community engagement and support in managing CKD effectively.