Are your kidneys ok? Detect early to protect kidney health

Capa

Citar

Texto integral

Acesso aberto Acesso aberto
Acesso é fechado Acesso está concedido
Acesso é fechado Acesso é pago ou somente para assinantes

Resumo

Early identification of kidney disease can protect kidney health, prevent kidney disease progression and related complications, reduce cardiovascular disease risk and decrease mortality. We must ask “Are your kidneys ok?” using serum creatinine to estimate kidney function and urine albumin to assess for kidney and endothelial damage. Evaluation for causes and risk factors for chronic kidney disease (CKD) includes testing for diabetes and measurement of blood pressure and body mass index. This World Kidney Day we assert that case-finding in high-risk populations, or even population level screening, can decrease the burden of kidney disease globally. Early-stage CKD is asymptomatic, simple to test for and recent paradigm shifting CKD treatments such as sodium glucose co-transporter-2 inhibitors dramatically improve outcomes and favor the cost-benefit analysis for screening or case-finding programs. Despite this, numerous barriers exist, including resource allocation, healthcare funding, healthcare infrastructure and healthcare-professional and population awareness of kidney disease. Coordinated efforts by major kidney non-governmental organizations to prioritise the kidney health agenda for governments and aligning early detection efforts with other current programs will maximise efficiencies.

Texto integral

Acesso é fechado

Sobre autores

Joseph Vassalotti

Mount Sinai Hospital

Email: st_roumeliotis@hotmail.com

Department of Medicine-Renal Medicine; National Kidney Foundation, Inc.

Estados Unidos da América, New York

Anna Francis

Queensland Children's Hospital

Email: st_roumeliotis@hotmail.com

Department of Nephrology

Austrália, South Brisbane, Queensland

Augusto Cesar Soares Dos Santos Jr

Universidade Federal de Minas Gerais

Email: st_roumeliotis@hotmail.com

Faculdade Ciencias Medicas de Minas Gerais, Hospital das Clinicas, Ebserh

Brasil, Minas Gerais

Ricardo Correa-Rotter

Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

Email: st_roumeliotis@hotmail.com
México, Mexico City

Dina Abdellatif

Cairo University Hospital

Email: st_roumeliotis@hotmail.com

Department of Nephrology

Egito, Cairo

Li-Li Hsiao

Harvard Medical School

Email: st_roumeliotis@hotmail.com

Renal Division, Department of Medicine, Brigham and Women's Hospital

Estados Unidos da América, Boston, Massachusetts

Stefanos Roumeliotis

Aristotle University of Thessaloniki

Autor responsável pela correspondência
Email: st_roumeliotis@hotmail.com

Second Department of Nephrology, AHEPA University Hospital Medical School

Grécia, Thessaloniki

Agnes Haris

Péterfy Hospital

Email: st_roumeliotis@hotmail.com

Nephrology Department

Hungria, Budapest

Latha Kumaraswami

Tamilnad Kidney Research (TANKER) Foundation

Email: st_roumeliotis@hotmail.com
Índia, Chennai

Siu-Fai Lui

The Chinese University of Hong Kong

Email: st_roumeliotis@hotmail.com

Division of Health System, Policy and Management, Jockey Club School of Public Health and Primary Care

Hong Kong, Hong Kong

Alessandro Balducci

Italian Kidney Foundation

Email: st_roumeliotis@hotmail.com
Itália, Rome

Vassilios Liakopoulos

Aristotle University of Thessaloniki

Email: st_roumeliotis@hotmail.com

Second Department of Nephrology, AHEPA University Hospital Medical School

Grécia, Thessaloniki

Bibliografia

  1. Ndumele CE, Neeland IJ, Tuttle KR, Chow SL, Mathew RO, Khan SS et al. A Synopsis of the Evidence for the Science and Clinical Management of Cardiovascular-Kidney-Metabolic (CKM) Syndrome: A Scientific Statement From the American Heart Association. Circulation. 2023;148(20):1636-64.
  2. Luyckx VA, Tuttle KR, Abdellatif D, Correa-Rotter R, Fung WWS, Haris A, et al. Mind the gap in kidney care: translating what we know into what we do. Kidney Int. 2024;105(3):406-17.
  3. Stevens PE, Ahmed SB, Carrero JJ, Foster B, Francis A, Hall RK et al. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney international. 2024;105(4):S117-S314.
  4. Guha C, Lopez-Vargas P, Ju A, Gutman T, Scholes-Robertson NJ, Baumgart A et al. Patient needs and priorities for patient navigator programmes in chronic kidney disease: a workshop report. BMJ Open. 2020;10(11):e040617.
  5. Collaboration GBDCKD. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395(10225):709-33.
  6. Cojuc-Konigsberg G, Guijosa A, Moscona-Nissan A, Nordmann-Gomes A, Canaviri-Flores VA, Braverman-Poyastro A et al. Representation of Low- and Middle-Income Countries in CKD Drug Trials: A Systematic Review. Am J Kidney Dis. 2024.
  7. Hsiao LL, Shah KM, Liew A, Abdellatif D, Balducci A, Haris A et al. Kidney health for all: preparedness for the unexpected in supporting the vulnerable. Kidney Int. 2023;103(3):436-43.
  8. Francis A, Harhay MN, Ong ACM, Tummalapalli SL, Ortiz A, Fogo AB et al. Chronic kidney disease and the global public health agenda: an international consensus. Nat Rev Nephrol. 2024;20(7):473-85.
  9. Foreman KJ, Marquez N, Dolgert A, Fukutaki K, Fullman N, McGaughey M et al. Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016–40 for 195 countries and territories. The Lancet. 2018;392(10159):2052-90.
  10. Viggiano D, Wagner CA, Martino G, Nedergaard M, Zoccali C, Unwin R et al. Mechanisms of cognitive dysfunction in CKD. Nat Rev Nephrol. 2020;16(8):452-69.
  11. Chen K, Didsbury M, van Zwieten A, Howell M, Kim S, Tong A et al. Neurocognitive and Educational Outcomes in Children and Adolescents with CKD: A Systematic Review and Meta-Analysis. Clinical journal of the American Society of Nephrology : CJASN. 2018;13(3):387-97.
  12. Francis A, Didsbury MS, van Zwieten A, Chen K, James LJ, Kim S et al. Quality of life of children and adolescents with chronic kidney disease: a cross-sectional study. Arch Dis Child. 2019;104(2):134-40.
  13. United States Renal Data System. 2023 USRDS Annual Data Report: Epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2023.
  14. Liyanage T, Ninomiya T, Jha V, Neal B, Patrice HM, Okpechi I et al. Worldwide access to treatment for end-stage kidney disease: a systematic review. The Lancet. 2015;385(9981):1975-82.
  15. Bello AK, Levin A, Tonelli M, Okpechi IG, Feehally J, Harris D et al. Assessment of Global Kidney Health Care Status. JAMA : the journal of the American Medical Association. 2017;317(18):1864-81.
  16. Ortiz A, Wanner C, Gansevoort R. Chronic kidney disease as cardiovascular risk factor in routine clinical practice: a position statement by the Council of the European Renal Association. Nephrol Dial Transplant. 2023;38(3):527-31.
  17. Johnson RJ, Wesseling C, Newman LS. Chronic Kidney Disease of Unknown Cause in Agricultural Communities. New England Journal of Medicine. 2019;380(19):1843-52.
  18. McCulloch M, Luyckx VA, Cullis B, Davies SJ, Finkelstein FO, Yap HK et al. Challenges of access to kidney care for children in low-resource settings. Nature reviews Nephrology. 2021;17(1):33-45.
  19. Stanifer JW, Muiru A, Jafar TH, Patel UD. Chronic kidney disease in low- and middle-income countries. Nephrol Dial Transplant. 2016;31(6):868-74.
  20. Levey AS, Schoolwerth AC, Burrows NR, Williams DE, Stith KR, McClellan W et al. Comprehensive public health strategies for preventing the development, progression, and complications of CKD: report of an expert panel convened by the Centers for Disease Control and Prevention. Am J Kidney Dis. 2009;53(3):522-35.
  21. Nephrology ISo. World Kidney Day 2025 [Available from: https://www.worldkidneyday.org/about-kidney-health/.
  22. Lloyd-Jones DM, Allen NB, Anderson CAM, Black T, Brewer LC, Foraker RE, et al. Life's Essential 8: Updating and Enhancing the American Heart Association's Construct of Cardiovascular Health: A Presidential Advisory From the American Heart Association. Circulation. 2022;146(5):e18-e43.
  23. Bello AK, Okpechi IG, Levin A, Ye F, Damster S, Arruebo S et al. An update on the global disparities in kidney disease burden and care across world countries and regions. The Lancet Global Health. 2024;12(3):e382-e95.
  24. Ferre S, Storfer-Isser A, Kinderknecht K, Montgomery E, Godwin M, Andrews A et al. Fulfillment and Validity of the Kidney Health Evaluation Measure for People with Diabetes. Mayo Clin Proc Innov Qual Outcomes. 2023;7(5):382-91.
  25. Alfego D, Ennis J, Gillespie B, Lewis MJ, Montgomery E, Ferre S et al. Chronic Kidney Disease Testing Among At-Risk Adults in the U.S. Remains Low: Real-World Evidence From a National Laboratory Database. Diabetes Care. 2021;44(9):2025-32.
  26. Stempniewicz N, Vassalotti JA, Cuddeback JK, Ciemins E, Storfer-Isser A, Sang Y et al. Chronic Kidney Disease Testing Among Primary Care Patients With Type 2 Diabetes Across 24 U.S. Health Care Organizations. Diabetes Care. 2021;44(9):2000-9.
  27. Kushner PR, DeMeis J, Stevens P, Gjurovic AM, Malvolti E, Tangri N. Patient and Clinician Perspectives: To Create a Better Future for Chronic Kidney Disease, We Need to Talk About Our Kidneys. Adv Ther. 2024;41(4):1318-24.
  28. Farrell DR, Vassalotti JA. Screening, identifying, and treating chronic kidney disease: why, who, when, how, and what? BMC Nephrol. 2024;25(1):34.
  29. Tuttle KR. CKD screening for better kidney health: Why? Who? How? When? Nephrol Dial Transplant. 2024;39(10):1537-9.
  30. Shlipak MG, Tummalapalli SL, Boulware LE, Grams ME, Ix JH, Jha V et al. The case for early identification and intervention of chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. 2021;99(1):34-47.
  31. Tummalapalli SL, Shlipak MG, Damster S, Jha V, Malik C, Levin A et al. Availability and Affordability of Kidney Health Laboratory Tests around the Globe. American journal of nephrology. 2020;51(12):959-65.
  32. Seegmiller JC, Bachmann LM. Urine Albumin Measurements in Clinical Diagnostics. Clin Chem. 2024;70(2):382-91.
  33. van Mil D, Kieneker LM, Heerspink HJL, Gansevoort RT. Screening for chronic kidney disease: change of perspective and novel developments. Curr Opin Nephrol Hypertens. 2024.
  34. Sacks DB, Arnold M, Bakris GL, Bruns DE, Horvath AR, Lernmark A et al. Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus. Clin Chem. 2023;69(8):808-68.
  35. Tonelli M, Dickinson JA. Early Detection of CKD: Implications for Low-Income, Middle-Income, and High-Income Countries. J Am Soc Nephrol. 2020;31(9):1931-40.
  36. Moreno JA, Martin-Cleary C, Gutierrez E, Rubio-Navarro A, Ortiz A, Praga M et al. Haematuria: the forgotten CKD factor? Nephrol Dial Transplant. 2012;27(1):28-34.
  37. Franceschini N, Feldman DL, Berg JS, Besse W, Chang AR, Dahl NK et al. Advancing Genetic Testing in Kidney Diseases: Report From a National Kidney Foundation Working Group. Am J Kidney Dis. 2024.
  38. Mjøen G, Hallan S, Hartmann A, Foss A, Midtvedt K, Øyen O et al. Long-term risks for kidney donors. Kidney International. 2014;86(1):162-7.
  39. Francis A, Abdul Hafidz MI, Ekrikpo UE, Chen T, Wijewickrama E, Tannor EK et al. Barriers to accessing essential medicines for kidney disease in low- and lower middle-income countries|. Kidney Int. 2022;102(5):969-73.
  40. Baigent C, Emberson J, Haynes R, Herrington WG, Judge P, Landray MJ et al. Impact of diabetes on the effects of sodium glucose co-transporter-2 inhibitors on kidney outcomes: collaborative meta-analysis of large placebo-controlled trials. The Lancet. 2022;400(10365):1788-801.
  41. Vart P, Vaduganathan M, Jongs N, Remuzzi G, Wheeler DC, Hou FF et al. Estimated Lifetime Benefit of Combined RAAS and SGLT2 Inhibitor Therapy in Patients with Albuminuric CKD without Diabetes. Clinical journal of the American Society of Nephrology : CJASN. 2022;17(12):1754-62.
  42. Vanholder R, Annemans L, Brown E, Gansevoort R, Gout-Zwart JJ, Lameire N et al. Reducing the costs of chronic kidney disease while delivering quality health care: a call to action. Nature reviews Nephrology. 2017;13(7):393-409.
  43. Berman-Parks N, Berman-Parks I, Gómez-Ruíz IA, Ardavin-Ituarte JM, Piccoli GB. Combining Patient Care and Environmental Protection: A Pilot Program Recycling Polyvinyl Chloride From Automated Peritoneal Dialysis Waste. Kidney International Reports. 2024;9(6):1908-11.
  44. Essue BM, Laba M, Knaul F, Chu A, Minh HV, Nguyen TKP et al. Economic Burden of Chronic Ill Health and Injuries for Households in Low- and Middle-Income Countries. In: Jamison DT, Gelband H, Horton S, Jha P, Laxminarayan R, Mock CN, et al., editors. Disease Control Priorities: Improving Health and Reducing Poverty. Washington (DC): The International Bank for Reconstruction and Development / The World Bank © 2018 International Bank for Reconstruction and Development / The World Bank.; 2017.
  45. Yeo SC, Wang H, Ang YG, Lim CK, Ooi XY. Cost-effectiveness of screening for chronic kidney disease in the general adult population: a systematic review. Clin Kidney J. 2024;17(1):sfad137.
  46. Cusick MM, Tisdale RL, Chertow GM, Owens DK, Goldhaber-Fiebert JD. Population-Wide Screening for Chronic Kidney Disease : A Cost-Effectiveness Analysis. Annals of internal medicine. 2023;176(6):788-97.
  47. Yadla M, John P, Fong VK, Anandh U. Ethical Issues Related to Early Screening Programs in Low Resource Settings. Kidney International Reports. 2024;9(8):2315-9.
  48. Szczech LA, Stewart RC, Su HL, DeLoskey RJ, Astor BC, Fox CH et al. Primary care detection of chronic kidney disease in adults with type-2 diabetes: the ADD-CKD Study (awareness, detection and drug therapy in type 2 diabetes and chronic kidney disease). PLoS One. 2014;9(11):e110535.
  49. Vassalotti JA, Centor R, Turner BJ, Greer RC, Choi M, Sequist TD et al. Practical Approach to Detection and Management of Chronic Kidney Disease for the Primary Care Clinician. Am J Med. 2016;129(2):153-62 e7.
  50. Thavarajah S, Knicely DH, Choi MJ. CKD for Primary Care Practitioners: Can We Cut to the Chase Without Too Many Shortcuts? Am J Kidney Dis. 2016;67(6):826-9.
  51. Vassalotti JA, Boucree SC. Integrating CKD Into US Primary Care: Bridging the Knowledge and Implementation Gaps. Kidney Int Rep. 2022;7(3):389-96.
  52. Luyckx VA, Moosa MR. Priority Setting as an Ethical Imperative in Managing Global Dialysis Access and Improving Kidney Care. Seminars in Nephrology. 2021;41(3):230-41.
  53. CDC. Chronic Kidney Disease in the United States 2023 [Available from: https://www.cdc.gov/kidneydisease/publications-resources/CKD-national-facts.html.
  54. Ritchie H. Does the news reflect what we die from? 2019 [cited 2022 Sept 8]. Available from: https://ourworldindata.org/does-the-news-reflect-what-we-die-from.
  55. Boulware LE, Carson KA, Troll MU, Powe NR, Cooper LA. Perceived susceptibility to chronic kidney disease among high-risk patients seen in primary care practices. J Gen Intern Med. 2009;24(10):1123-9.
  56. Foundation NK. Kidney Quiz 2024 [Available from: https://www.kidney.org/kidney-quiz/.
  57. Tuot DS, Crowley ST, Katz LA, Leung J, Alcantara-Cadillo DK, Ruser C et al. Usability Testing of the Kidney Score Platform to Enhance Communication About Kidney Disease in Primary Care Settings: Qualitative Think-Aloud Study. JMIR Form Res. 2022;6(9):e40001.

Arquivos suplementares

Arquivos suplementares
Ação
1. JATS XML
Baixar
2. Fig. 1. Risk factors for CKD

Baixar (368KB)
Metadados
3. Fig. 2. Conceptual framework of a CKD testing, risk stratification, and treatment program, see reference [30]

Baixar (155KB)
Metadados