Kidney health for all

We in our lifetime can get various diseases which can affect an organ or multiple organs. Knowledge about the function of various organs and the diseases that affect these organs will go a long way to help in better management and even prevent various diseases.

Globally a particular day has been earmarked for a particular organ/disease, on which the general population, through various awareness campaigns, is made aware about. For knowing more about our kidneys, we have the World Kidney Day (WKD).

WKD is held every year throughout the globe on the 2nd Thursday of March. What began as small initiative in 2006 has expanded into a world-wide campaign to aware the common man about various aspects of kidney health.

Every year there is a theme put forth by experts with an aim to reduce the frequency of kidney diseases, help to retard the progression who already have early kidney disease by timely and appropriate intervention.

With the efforts put in for more than seven decades the authorities have been able to manage most communicable diseases, the leading cause of mortality in our country. The focus in last five years has shifted to deal with non-communicable diseases (NCDs), including diabetes, hypertension, chronic lung disease, chronic kidney disease (CKD), cardio-vascular diseases and cancer, which are known to be the leading causes of death and disabilities worldwide.

CKD is estimated to affect a billion people worldwide and result in over 3 million deaths in the coming decade. Presently, kidney disease ranks as the 8th leading cause of death, and if left unaddressed, it is projected to be the 5th leading cause of years of life lost by 2040.

The main aim of this year’s WKD is equitable access and on this front, I will try to put how we have achieved this. In our valley two decades back the nephrologists to treat kidney diseases and the modalities for managing kidney diseases (Dialysis) were available at SKIMS only and one or two private dialysis centers in Srinagar city only.

These facilities were afforded by the affluent and those living within the reaches of SKIMS, while the poor and those living far away were not lucky to get specialist consultation and dialysis. Likewise, kidney transplant as the best modality was available at SKIMS only and only a few could avail of this modality.

But thankfully equitability has been addressed as many specialists are now available to deal with the increasing number of patients and the same is available in all districts. This is due to the DM and the DNB programs at the national level and the ones started at SKIMS and SMHS in the last 4 years.

Those in need of dialysis now can get it at all the district hospitals under the national dialysis program and at the units set under the private-public partnership as well as many private dialysis centers set up throughout Kashmir (about 40) making this modality available to all.

Moreover, providing dialysis under the central/state sponsored scheme has made it available to the rich and the poor. Having medications available in the generic forms on a large scale has also resulted in them being available to one and all at affordable rates.

Much to the relief for those in need of kidney transplant the surgery is now being conducted at GMC Jammu and SSH Srinagar. This is the equitable part of health care being given to one and all. There still may be limitations on this front but efforts are on to improve the gaps in early diagnosis, provide universal healthcare or insurance coverage, improve awareness among healthcare workers, and address challenges to medication cost and accessibility.

Over the last three decades, CKD treatment efforts have centered on preparing for and delivering kidney replacement therapies which we have be able to give to our patients.

However, recent therapeutic breakthroughs offer unprecedented opportunities to prevent or delay disease and mitigate complications such as cardiovascular disease and kidney failure, ultimately prolonging the quality and quantity of life in CKD patients.

Access to kidney disease screening, tools for early diagnosis, and sustainable access to quality treatment are the inequities we need to shift our focus on by addressing the following:

Health Policies – primary and secondary preventive strategies adopted by the government should include kidney health programs, secure funds for kidney care and disseminate kidney health knowledge to both the public and healthcare workers to prevent CKD or its progression.

Healthcare Delivery- should be enhanced by a formidable policy, adequate patient and caregiver education, availability of resources for quality care and access to affordable and latest medication.

Enhancing health care force - Despite huge increase in the number of specialists and super-specialists there is still a deficiency of the nephrologists, healthcare providers in field of dialysis as well as primary care physicians, nurses. Enhancing this manpower will help in appropriate CKD screening and adherence to clinical practice guideline recommendations will go a long way to tackle kidney ailments.

Empowering All – getting people aware of the risk factors of CKD, knowing the benefits of life style  modifications, ensuring adherence to treatment modalities can have lasting benefits when initiated early and kept consistent. Giving patients the role to disseminate the benefits in the community will further empower and improve the outcomes.

With awareness through various campaigns done on the WKD, we in Kashmir can help people, and guide the authorities, to make plans to manage patients with kidney diseases with equitable facilities and prompt preventive strategies. 

Dr Muzafar Maqsood Wani, Consultant Nephrologist, SKIMS, Soura