World Kidney Day (WKD) is an annual world-wide program, held on 2nd Thursday of March, to increase awareness amongst the people about the importance of their kidneys.
The main aim of celebrating this day has been to reduce the frequency of kidney diseases in high risk population, help to retard the progression in patients who already have early kidney disease by timely and appropriate intervention, and also stress the concerned authorities to cater more to patients with kidney diseases.
WKD began 17 years back as joint initiative of two international foundations but over years has involved renal societies, NGO’s, celebrities, governments as well as the common man. This year on 10th of March we are celebrating the 17th WKD with quite a different theme “Living well with Kidney Disease – Bridge the Knowledge gap to better Kidney care”.
Chronic kidney disease affects 1 in 10 individuals worldwide and will be the 5th leading cause of death by 2040. Kidney disease is a nightmare both for a person suffering from such disease (especially in its late stages) as well as to the family.
Once a person is labelled with chronic kidney disease, it is a drag on all the family members as nearly everyone in the family is involved directly or indirectly.
End stage Kidney disease luckily has some form of replacement available unlike many other diseases. Both dialysis and transplant prolong longevity by preserving, restoring or substituting kidney function and delivering relief from kidney failure.
With the present dialysis and transplant facilities a person with renal failure can live well, socialise, maintain their job thus maintaining some semblance of normality and wellbeing. Our health care set up is stuck in the times when the doctors would take the decision on part of the management of a patients’ disease.
This in turn leads to patients frequently perceiving treatment as being imposed and out of their control. This is because a knowledge gap exists in all aspects of the health care regarding kidneys diseases. Be it the –
The community: Obstacles to better kidney health understanding include the complex nature of kidney disease information, low baseline awareness, limited health literacy, limited availability of CKD information, and lack of readiness to learn. This is true especially in the rural setting and also to lack of education of our population.
The healthcare worker: Another barrier to overcome in order to ensure greater awareness is a more focused education of physicians, as they are the paramedical staff and nursing personnel who are incharge of such patients.
The public health policy makers: CKD is a global, public health threat which unfortunately is typically low on government health agendas with more concentration on four main diseases – cardiovascular disease, cancer, diabetes and chronic respiratory disease. CKD needs to be added to this list sooner than later.
This knowledge gap is hampering the fight against kidney disease, and increasing the inherent associated mortality. This has been taken care to a large extent in the urban areas and the present educated population but it still is there in the rural areas and the uneducated lot. We need to involve patients not only in their proper and best management but also keep them as part in research, policy as well as in practice.
For patients to be more content, engaged and constructive with regard to their treatment, and thereby improving clinical outcomes, they need to feel that their symptoms are effectively managed and to be actively motivated to become participants in their treatment. Ensuring their participation is important for both patients and their care-givers, contrary to feeling left alone and constrained by the current approach to treating kidney disease.
This year the world nephrology community calls for everyone to not only be aware of the disease, but to actively know what their own kidney health measures are. For example, what their blood pressure is, and what the treatment objectives is. It is a cause that involves all of us in the kidney community worldwide — physicians, scientists, nurses and other health-care providers, patients, administrators, health-policy experts, government officials, nephrology organisations, and foundations.
All need to be aware of the ways in which more attention to the kidney in the setting of government policies can lead to major benefits both to patients and to health-care budgets, which includes; Encourage general public to adopt healthy diet and lifestyles (access to clean water, exercise, healthy diet, tobacco control, and climate change prevention) to maintain good kidney health, preserve kidney function longer in those with CKD, and increase overall general awareness of the importance of kidneys.
Extend kidney patient education (including practical advice on diet and lifestyle) to empower patients, their care-partners, and their support systems to achieve the health outcomes and life goals that are meaningful and important to those with CKD including kidney failure. Recognise patients’ and caregivers’ right to be able to assess, understand and use health information related to CKD.
Require kidney healthcare providers and patient organisations to offer information related to CKD according to varying levels of health literacy. Encourage and support primary care physicians to improve their recognition and management of patients with CKD across its entire spectrum from prevention and early detection of CKD to its secondary and tertiary prevention and kidney failure care.
Integrate CKD and kidney failure prevention into national non-communicable disease programs for comprehensive and integrated services, which are essential in improving the early detection and tracking of kidney care at country level
Inform politicians about the impact of kidney disease and kidney failure on their constituents’ health and its associated burden on healthcare budgets/systems to encourage the adoption of policies and allocation of resources which tackle the global burden of kidney disease and ensure living well with kidney disease.
All of these measures need to be supported by consistent, accessible and meaningful communication. Bridging this knowledge gap is the need of the hour and can go a long way in empowering, partnering and communicating better with the patient and eventually inspire confidence in those who need it the most. We need to implement these policies so that patients with CKD live well.
Dr Muzafar Maqsood Wani, Consultant Nephrologist, SKIMS, Soura
Disclaimer: The views and opinions expressed in this article are the personal opinions of the author.
The facts, analysis, assumptions and perspective appearing in the article do not reflect the views of GK.