Every year World Kidney Day is celebrated on 14 March, and this year’s campaign aims at raising global awareness about the increasing kidney diseases and also about the need for strategies for kidney disease prevention and management.
It is estimated that around 850 million people worldwide are now suffering from kidney disease of various types, of which Chronic Kidney Disease (CKD) and Acute Kidney Injury (AKI) account for the most. CKD causes at least 2.4 million deaths per year and now it has become the sixth fastest growing reason of death globally. On the other hand, AKI affects over 13 million people worldwide, among whom 1.7 million die annually. AKI and CKD are called Disease Multipliers as it contributes to increased mortality and morbidity from other diseases such as Diabetes, Hypertension, Obesity, Cardiovascular disease, Malaria, Tuberculosis, Hepatitis, and so on.
In Bangladesh, different surveys have found that more than 20 million people are suffering from kidney diseases, and 5 people die every hour from the disease. The only treatment for end stage renal disease is either Kidney Transplantation or Dialysis. However, due to its high cost only 10 per cent people can avail both treatments while 80 per cent die without treatment.
This excessive annual growth in kidney disease creates extra health burden and healthcare challenges for the government. So, specific policies and strategies should be made aiming screening and prevention of kidney disease. In this regard, KAMPS (Kidney Awareness Monitoring and Prevention Society) Bangladesh has been working successfully for the past one and a half decades through screening thousands of people and preventing kidney diseases.
This year, World Kidney Day’s theme “Healthy Kidney for Everyone Everywhere” calls for universal health coverage for prevention and early treatment of kidney diseases.
Some specific measures can be taken to prevent kidney diseases such as —
• Encourage and adopt healthy lifestyles: There are some non-modifiable causes of kidney disease such as Familial Kidney Disease, age, sex and Congenital Kidney Disease. Apart from these, 90% causes of kidney disease are related to modifiable cause such as Diabetes, Hypertension, Smoking, Obesity, Sedentary lifestyle and taking adulterated unhealthy foods. Therefore, in 50-60% cases, kidney diseases can be prevented by raising awareness and leading a healthy lifestyle.
• AKI can occur after Diarrhoea, vomiting, Haemorrhage, severe infection such as with Malaria, Dengue, Hepatitis and after taking adulterated foods. So to prevent it, measures have to be taken such as access to clean water, healthy food, ORS, maintaining proper hygiene, taking vaccines etc.
• Usually Kidney Disease is a silent killer. No signs and symptoms can be seen unless 70-80% of the kidneys have been damaged. So, those who are at high risks for kidney disease should have regular screening for it. High risk persons are those who have diabetes, hypertension, and are smoker and obese, have familial kidney diseases and lead sedentary lifestyle, take unhealthy foods and regular painkillers, have kidney stones, recurrent urinary tract infection, aged more than 50 years. These high risk groups should have regular check-up at least every 6 months for any latent kidney disease. Kidney disease can be identified by checking urine for micro albumin and by eGFR from S Creatinine. If government can make only these two tests available free of cost at all community levels, maximum kidney diseases can be screened at early stage and hence measures can be taken to prevent their progression.
• Prevention of the major causes of kidney disease such as Hypertension, Diabetes, high cholesterol levels for which medications should be easily accessible to all. Poor patients should have access to these medications free of charge.
• For end stage renal disease the only treatment is either Kidney Transplantation or Dialysis. But these treatment modalities are very expensive and 90% people cannot cope up with the treatment. So, our government should make transparent polices to have access to advanced healthcare services such as with dialysis or transplantation and give better financial protection either providing with subsidies those in need or having health insurance policy irrespective of socioeconomic barriers to provide equitable kidney care.
Professor Dr M A Samad is Founder and President, Kidney Awareness Monitoring & Prevention Society (KAMPS)