World Kidney Day, March 12 |12 March 2020

‘Kidney health for everyone everywhere – from prevention to detection and equitable access to care’

Amsa Renal Care Seychelles has been celebrating the World Kidney Day on March 12 every year since 2015 by conducting screening programmes, walks to raise awareness about kidney health, educational sessions with patients and health care workers.

The activities for this year have been curtailed due to the ongoing epidemic of coronavirus. But Amsa wouldn't like to miss this opportunity to be a part of this global event.

World Kidney Day is a global campaign aimed at raising awareness of the importance of our kidneys to our overall health and to reduce the frequency and impact of kidney disease and its associated health problems worldwide.

World Kidney Day started in 2006 and has not stopped growing ever since. Every year, the campaign highlights a particular theme.

The theme for this year is ‘Kidney Health for Everyone Everywhere – from Prevention to Detection and Equitable Access to Care’.

Burden of kidney disease

Kidney disease is a non-communicable disease (NCD) and currently affects around 850 million people worldwide. One in ten adults has chronic kidney disease (CKD). The global burden of CKD is increasing, and is projected to become the 5th most common cause of years of life lost globally by 2040. Chronic kidney disease is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume 2–3% of the annual health care budget in high-income countries, spent on less than 0.03% of the total population of these countries. In low-income and middle-income countries, most people with kidney failure have insufficient access to lifesaving dialysis and kidney transplantation.

Crucially, kidney disease can be prevented and progression to end-stage kidney disease can be delayed with appropriate access to basic diagnostics and early treatment. However, while national policies and strategies for NCDs in general are present in many countries, specific policies directed toward education and awareness about kidney disease as well as CKD screening, management and treatment are often lacking. There is a need to increase the awareness of the importance of preventive measures throughout populations, professionals and policy makers.

This year World Kidney Day continues to raise awareness of the increasing burden of kidney diseases worldwide and to strive for kidney health for everyone, everywhere. Specifically, the 2020 campaign highlights the importance of preventive interventions to avert the onset and progression of kidney disease.

What is a preventive intervention?

The term “prevention” refers to activities that are typically categorised by the following three definitions: (1) Primary Prevention, implies intervening before health effects occur in an effort to prevent the onset of kidney disease before the disease process begins; (2) Secondary Prevention suggests preventive measures that lead to early diagnosis and prompt treatment of kidney disease to prevent more severe problems developing and (3) Tertiary Prevention indicates managing kidney disease after it is well established in order to control disease progression and the emergence of more severe complications.

Specifically, primary prevention of kidney disease requires the modification of risk factors, including diabetes mellitus and hypertension, unhealthy diets, structural abnormalities of the kidney and urinary tracts, and/or nephrotoxicity levels. Preventative primary interventions include promoting of healthy life styles including physical activity and healthy diets, screening for patients at higher CKD risk with the aid of urine and blood tests and keeping screening data in a CKD registry.

In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimisation and glycemic control, is the main goal of education and clinical interventions which can be achieved by low salt and protein, as well as plant-based diets and pharmacotherapy.

In patients with advanced CKD, management of co-morbidities such as uremia[1] and cardiovascular disease is of high priority.

Such preventive measures of CKD are becoming ever more important, with rising levels of cases worldwide. As CKD is associated with high costs, preventive measures addressing root causes, especially in the form of primary prevention, have significant value. Raising awareness and educating individuals on the most important risk factors and preventative measures for kidney disease is hence important so as to reduce the burden of kidney disease. In order for the importance of the “Prevention approach” of kidney disease and kidney failure to be recognised, promotion programmes for health care professionals including nephrology fellowship programmes and non-specialist training; effective and efficient education and awareness programmes for the general population and partnerships for patient empowerment are key.

In 2020, World Kidney Day calls on everyone to advocate for concrete measures to promote and advance kidney disease prevention.

Amsa in Seychelles has always worked to advocate such measures like including CKD screening into the NCD programme, creating awareness among public about prevention of kidney disease, and imparting knowledge about early detection, management and timely referral to the doctors in the community.

Contributed by Syed Noufel/Amsa