BY TEWODROS KASSA
According to the World Health Organization (WHO) report on kidneys, early prevention of chronic kidney diseases is possible through properly implementing physicians’ recommendations. Practicing physical exercise, healthy diet, and healthy weight, taking enough amounts of liquid, and limit alcohol intake among others are recommended by health experts to ensure our kidney’s health. What is more, manage diabetes, high blood pressure, and heart disease are equally important to keep kidneys Healthy.
Properly adhering to health professional recommendations regarding the kidney is important to counter the adverse health impacts of kidney failure. According to the 2010 Global Burden of Disease study, chronic kidney disease was ranked 27th on the list of causes of the total number of deaths worldwide in 1990 but rose to 18th in 2010. This degree of movement up the list was second only to that for HIV and AIDs. Currently, over 2 million people worldwide receive treatment with dialysis or a kidney transplant to stay alive, yet this number may only represent 10 percent of people who need treatment to live.
In a press release sent to The Ethiopian Herald a global science-led biopharmaceutical company AstraZeneca highlighted that lack of awareness of Chronic Kidney Disease (CKD) and its risk factors is leaving this life-threatening condition underdiagnosed and undertreated across the Middle East and Africa. This was the warning issued by eminent healthcare professionals from the Middle East and Africa regions, who also proposed a series of measures to prevent cases from continuing to rise and to improve outcomes for people already living with CKD.
Accordingly, CKD is a major cause of morbidity and mortality in developing and developed countries. It is associated with 35.8 million disability-adjusted life years (DALYs), one-third of which is attributed to diabetic kidney disease. The research done by the physicians demonstrates that, despite the severity and prevalence of CKD, steps to improve the prevention and treatment of the disease in the region remain minimal. It notes that many primary healthcare professionals are not trained to identify CKD warning signs and that novel and upcoming therapies that have been shown to improve kidney outcomes are not equally accessible across different healthcare settings in the regions.
The panel of experts recommended that governments and health care providers should take urgent measures to improve patient outcomes, including awareness campaigns; increased screening; augmentation of epidemiological studies to include more participants from these regions; implementation of evidence-based international guidelines related to CKD; and improved access to novel therapies.
“The rise of Chronic Kidney Disease in the Middle East and Africa is alarming but not inevitable. However, researches present a set of clear and cost-effective measures for governments to take to stem the rise in cases and slow the progression of the disease in those who already live with it, while also tackling life-limiting risk factors including diabetes and hypertension,” said Sheikh Khalifa Medical City Consultant and Nephrologist Professor Mohamed Hassan.
“Tackling the growing burden of Noncommunicable Diseases (NCDs), including Chronic Kidney Disease, should be a priority for governments in our region. To do this effectively, more epidemiological studies looking specifically at patients with CKD in the Middle East and Africa must be performed,” said Dr. Ali Abu-Alfa, Professor of Medicine and Head of the Division of Nephrology and Hypertension at the American University of Beirut in Lebanon.
The publication acknowledges that low- and middle-income countries (LMICs) can face additional hurdles to tackling the rise of CKD, including a lack of functional health insurance systems to secure access to novel treatments. To address this disparity, it suggests real-world studies to evaluate the cost-effectiveness of novel therapies and financial support or subsidized programs to ensure their availability.
Moreover, emerging evidence suggests that the proper care of patients with CKD risk factors, such as diabetes, remains unaddressed despite the availability of consensus statements and guidelines. Studies from the Middle East have highlighted the lack of awareness among the medical community as well as the general public related to the recent preventive and therapeutic advancements. The prevalence of CKD risk factors, such as diabetes, obesity, and hypertension, is high in the Middle East and African countries. This lack of epidemiological data is considered a stumbling block for the effective implementation of preventive policies.
The experts underscored that there are considerable gaps in terms of awareness and screening of CKD, owing to its asymptomatic presentation until the advanced stage. Further, there is ambiguity about the role of primary care physicians and non-nephrology specialists in identifying patients at risk of CKD; underutilization of urine albumin values for screening; and the lack of several aspects, including CKD registry, clear criteria for identifying high-risk patients, the interaction between scientific societies related to kidney health, awareness about unregulated use of NSAIDs, and community education.
In sum, the lack of early diagnosis of CKD and its risk factors is another common concern. Chronic Kidney Disease is often underdiagnosed and undertreated in primary care settings. Kidney disease related to diabetes is underreported in the Middle East and Africa. Accurate estimation of Glomerular Filtration Rate (GFR), a means used to measure how well kidneys filter blood and an essential method to the diagnosis of CKD, may be a challenge in resource-limited countries, as the population-wide estimated glomerular filtration rate (eGFR) validation studies to evaluate and suggest an appropriate equation for such population are generally lacking.
Additionally, lack of reimbursement (for creatinine or albumin evaluations) and access to healthcare facilities prevent the early diagnosis of CKD, the experts stressed. However, as the experts recommend, it is wiser to be cautious and careful and take the necessary care beforehand in order to avoid possible unpleasant consequences.
THE ETHIOPIAN HERALD TUESDAY 25 APRIL 2023
