This World Kidney Day, ask yourself: “Are Your Kidneys OK?”
Everyone must know about the function of various organs and the common diseases that affect these organs. This will go a long way to help prevent, better manage and even retard the ill effect of these diseases in long term.
A particular day is earmarked for a particular organ/disease, on which the general population, through various awareness campaigns, is made aware about. We have the World Kidney Day (WKD) to inform the common person about various aspects of kidney health and how to deal with the diseases that affect the kidneys. WKD began as a small initiative in 2006 and has expanded into a worldwide campaign, it is celebrated on the 2nd Thursday of March every year, and this year on 13th March we are celebrating the 20th WKD.
Every year there is a theme put forth by experts with an aim to tell people about the importance of their kidneys, the diseases that affect it commonly, how to keep them safe, reduce the frequency of kidney diseases, and retard the progression of those who already have early kidney disease by timely and appropriate intervention. This year the theme is - ARE YOUR KIDNEYS OK? DETECT EARLY, PROTECT KIDNEY HEALTH.
Kidney diseases are often called ‘silent killers’ as they progress without noticeable symptoms until significant kidney damage has happened. Chronic Kidney Disease (CKD) is estimated to affect approximately 850 million people worldwide. If left undetected and not treated timely, overtime CKD can progress to kidney failure, leading to severe complications and premature mortality (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, highlighting the urgent need for global strategies to combat kidney disease. This makes early detection important in preserving kidney function and preventing complications.
There are some risk factors for a person to have his kidney damaged permanently. In present day scenario the major risk factors are - Diabetes, Hypertension, Cardiovascular disease, Obesity, family history of kidney disease. To a lesser extent having past history of acute kidney injury, pregnancy-related kidney disease, autoimmune diseases, low birth weight or being borne prematurely or having birth defects affecting the kidneys or urinary tract , urinary tract obstruction, recurrent kidney stones are also responsible. In our part of the world, heat stress in farmers, snakebites, environmental toxins, traditional medicines, infections like hepatitis B or C, HIV, and parasites are also some reasons of having ones kidneys affected.
Rather than allowing these high-risk patients to reach us at a time when their only remedy will be need of dialysis and kidney transplantation, it is important to prevent them from reaching that stage. Screening initiatives have far-reaching consequences in improving the overall care of these vulnerable patients and should be considered as an approach to improve global health. Access to kidney disease screening, tools for early diagnosis, and sustainable access to quality treatment are the ways we can prevent a person from reaching a stage where he needs dialysis or kidney transplant for survival.
Simple, non-invasive, and cost-effective tests for high-risk populations include - Blood pressure measurements, Body Mass Index (BMI) estimation, testing albumin in urine (albuminuria) by a routine urine test or more precisely by Urinary Albumin-Creatinine Ratio (uACR), blood tests including fasting or random glucose & HbA1c, serum creatinine to estimate Glomerular Filtration Rate (eGFR). These measures are easy to do except for the blood tests, which have been simplified for blood glucose estimation by hand, held glucometers and test strips. Presently kidney function tests need a blood sample to be drawn (a disadvantage) but soon handheld meters that measure creatinine and calculates eGFR from a capillary finger stick in just thirty seconds will fill an urgent need for screening and early detection of kidney disease in community settings.
Early detection policies for at risk individuals should be implemented globally to reduce the healthcare costs associated with kidney failure and improve quality of life. Although the economic burden of screening is substantial, many countries have adopted screening initiatives into their existing national programs. Recognition of CKD as a major non-communicable disease by international bodies will help to improve global kidney care overall. Primary care clinicians and frontline health workers should be trained to integrate CKD testing into routine care for high-risk populations. CKD testing should be integrated into existing community interventions (e.g., those targeting maternal health, HIV, TB, and other non-communicable diseases) to decrease cost and enhance efficiency. Testing may also occur outside of medical settings, such as in community centers, religious places, or malls/markets, depending on local regulations and available resources.
Getting people to be 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. Efforts should also focus on raising awareness of screening tests among the general population about the non-communicable diseases. This will go a long way to tackle many diseases including kidney ailments.
With awareness through various campaigns done on WKD and intermittently throughout the year, we in Kashmir can help people and as well guide the authorities to make plans to manage patient with kidney diseases with screening ,prompt preventive strategies and providing equitable facilities.
Dr Muzafar Maqsood Wani is Consultant Nephrologist, SKIMS, Soura
