Chronic kidney disease and the global public health agenda: an international consensus
Kidney disease is an important public health concern, impacting over 850 million people world-wide. Access to kidney care is highly inequitable across the globe and the cost of its provision is prohibitive for many lower income countries. Millions of people die every year because of lack of access to simple early diagnosis and unaffordable care ranging from simple medications at primary care level to dialysis and transplantation once the kidneys fail.
On April 3, 2024, Nature Reviews Nephrology published a groundbreaking international consensus statement highlighting kidney disease as a leading contributor to premature mortality among non-communicable diseases (#NCDs).
Chronic kidney disease and the global public health agenda: an international consensus
Anna Francis, Meera N. Harhay, Albert C. M. Ong, Sri Lekha Tummalapalli, Alberto Ortiz, Agnes B. Fogo, Danilo Fliser, Prabir Roy-Chaudhury, Monica Fontana, Masaomi Nangaku, Christoph Wanner, Charu Malik, Anne Hradsky, Dwomoa Adu, Sunita Bavanandan, Ana Cusumano, Laura Sola, Ifeoma Ulasi, Vivekanand Jha, American Society of Nephrology, European Renal Association & International Society of Nephrology
A strategic objective of the ISN toward advancing kidney health worldwide is to advocate with the WHO to prioritize kidney health as an important non-communicable disease (NCD) on the global health agenda, as has been done for cardiovascular diseases, cancer, respiratory disease, diabetes and mental health. Toward that end, ISN has developed additional materials in support of the international consensus statement.
| [Brussels, Belgium, April 4, 2024] – On April 3, 2024, Nature Reviews Nephrology published a landmark international consensus statement titled “Chronic Kidney Disease and the Global Public Health Agenda: An International Consensus.” Authored by a coalition of leading experts, stakeholders, and nephrology societies, the publication highlights critical policy, advocacy, and implementation needs to alleviate the growing burden of kidney disease worldwide. |
| “In contrast to cardiovascular disease, stroke, and respiratory disease, chronic kidney disease (CKD) mortality rates have been on a troubling rise. Presently, kidney disease stands as the third fastest-growing cause of death worldwide, with deaths attributable to kidney disease surged by 50% from 2000 to 2019,” notes Masaomi Nangaku, president of the International Society of Nephrology. |
| CKD and acute kidney injury (AKI) present significant challenges to global health, particularly in low- and middle-income countries (LMICs) where access to care and preventive services is limited. The World Bank highlights that CKD is responsible for the largest number of people suffering catastrophic healthcare expenditures annually, particularly in LMICs. More than one million individuals with potentially reversible AKI succumb yearly due to the lack of timely therapies, including dialysis, underscoring the urgency of addressing access gaps in healthcare services. |
Key recommendations from the international consensus include:
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| The consensus statement deplores the underrepresentation of kidney disease in media and public discourse, with an 11-fold disparity between discussed versus actual causes of death. |
| “This consensus statement marks a significant first step in recognizing the impact kidney diseases have on more than 850,000,000 people globally and the need to eliminate disparities in kidney health and achieve equity in kidney care for people from all walks of life. I believe that the World Health Organization (WHO) and governments worldwide will rise to meet this call to action,” declares Deidra Crews, president of the American Society of Nephrology. |
| The 2015 United Nations Sustainable Development Goal 3.4 aims to reduce premature mortality from NCDs by a third by 2030. To tackle this goal, the WHO has recognized cancer, heart disease, stroke, chronic lung disease and diabetes as the major NCD drivers of early mortality. Failure to include kidney disease in this initiative misses the opportunity to address a major contributor to premature and preventable mortality. |
| “Kidney disease is under-recognized and under-resourced. Recognizing the silent yet pervasive impact of kidney disease as a leading driver of NCDs, our three societies can mobilize joint efforts to save lives and enhance health outcomes globally. Through collaborative efforts, we can amplify awareness, allocate resources, and prioritize global kidney health in our pursuit of a healthier, more equitable future for all,” concludes Christoph Wanner, president of the European Renal Association. |
| For more information, please refer to the full publication in Nature Reviews Nephrology. |
Suman Behera, WCN’24 Social Media Team Member, Canada
Chronic Kidney Disease and the Global Public Health Agenda” at WCN’24
The ISN hosted an interview during the WCN’24 with ISN Past-president Vivek Jha and Monica Wang, Senior Editor at Nature Reviews Nephrology. The publication “Chronic Kidney Disease and the Global Public Health Agenda: An International Consensus” was discussed, emphasizing the need to prioritize CKD due to its rising prevalence and impact on mortality. Prof. Jha highlighted effective therapies and the importance of CKD recognition by the WHO. Monica Wang underscored the role of journals in disseminating critical kidney health information. The Global Kidney Health Atlas was highlighted as a resource for understanding and advocating for kidney disease prioritization in healthcare policies.
Chronic Kidney Disease and the Global Public Health Agenda” at WCN’24
Monica Wang, Senior Editor, Nature Reviews of Nephrology, presents the role that journals can have in helping to facilitate the translation of research insights into evidence-informed policy.
Vivek Jha, ISN Past-president, presents on grand challenges for kidney health as per the Nature Reviews of Nephrology publication, “Chronic Kidney Disease and the Global Public Health Agenda: An International Consensus.”
Chronic kidney disease and the global public health agenda: an international consensus
Infographic by Denisse Arellano
Kidney health within the broader non-communicable disease agenda
Kidney disease is strongly linked with cardiovascular diseases, hypertension, diabetes, infections and other health conditions, as well as social determinants of health and climate change. Consequently, a holistic approach to promote well-being, protect individual health and improve access to quality primary care will support kidney health.
Time to sound the alarm about the hidden epidemic of kidney disease
With rates rising around the world, public-health leaders must prioritize prevention, treatment, funding and data.
Kidney disease is growing worldwide. The secretariat of the World Health Organization has welcomed the call to include it as a non-communicable disease that causes premature deaths.
A patient perspective on kidney disease in the public health agenda
Daniel Gallego
Chronic kidney disease is a life-changing diagnosis for millions of people worldwide, as the risk of disease progression and kidney failure creates unbearable uncertainty and limits lifestyle. The devastating impact of advanced kidney disease must be acknowledged in the public health agenda to pave way for improved outcomes for patients at all stages of disease.
Kidney health matters: a global imperative for public health
Roser Torra
Kidney disease has long been overshadowed by other global health priorities. The World Health Organization (WHO) lists heart disease, stroke, cancer, diabetes, and chronic lung disease as the top five non-communicable diseases (NCDs) causing premature death and disability
Time To Act: A New Review of Kidney Health Inequalities
The report, Time To Act: A New Review of Kidney Health Inequalities, is authored by an academic, clinical and patient team and comes five years after the charity’s previous report of kidney health inequalities outlined recommendations for change in clinical and research practice. The new review exposes the limited progress since 2018, impacting people’s health and risk of disease.
An update on the global disparities in kidney disease burden and care across world countries and regions
Bello AK, Levin A, Okpechi IG, et al. An update on the global disparities in kidney disease burden and care across world countries and regions. The Lancet Global Health. 2019;367:l5873. Published 2024 Feb 14.
doi: 10.1016/S2214-109X(23)00570-3.
WKD 2024 Scientific Editorial – Mind the gap in kidney care: translating what we know into what we do
It takes an average of 17 years to move new treatments from clinical evidence to daily practice, which is too long given the effective treatments available for kidney disease. We must close the gap between knowledge and action. Despite clear guidelines for managing risk factors like hypertension and diabetes, few people are diagnosed or treated properly. Most with kidney disease are unaware of their condition until it’s advanced. Early and appropriate treatment is crucial to prevent serious consequences. Diagnosing and treating kidney disease early should start at the primary care level. Barriers exist at all levels, from patients to health systems. To improve kidney health globally, we must acknowledge and address these barriers with sustainable solutions immediately.
Infographics
#KidneyHealthMatters in Women – X Space Recording
Experts:
Fiona Loud, UK
Ifeoma Ulasi, Nigeria
Valerie Luyckx, Switzerland
With:
Rasha Darwish, Egypt
Roser Torra, Spain
Smita Divyaveer, India
Hosts:
Manjusha Yadla, India
Milagros Flores, Mexico
Suman Behera, Canada