Schyłkowa niewydolność nerek – Zapobieganie i profilaktyka

Schyłkowa niewydolność nerek
Zapobieganie i profilaktyka

Schyłkowa niewydolność nerek (ESRD) stanowi końcowe stadium przewlekłej choroby nerek (PChN), w którym funkcja nerek jest niewystarczająca do podtrzymania życia bez dializoterapii lub przeszczepienia. Kluczowe jest wczesne wykrywanie i profilaktyka, obejmująca kontrolę głównych czynników ryzyka, takich jak cukrzyca i nadciśnienie tętnicze, oraz modyfikację stylu życia, w tym dietę roślinną, ograniczenie spożycia sodu i potasu, unikanie nefrotoksycznych leków (zwłaszcza NLPZ), zaprzestanie palenia i ograniczenie alkoholu. W profilaktyce wtórnej stosuje się inhibitory układu renina-angiotensyna-aldosteron (RAASi), agresywną kontrolę ciśnienia tętniczego i glikemii, korektę kwasicy za pomocą wodorowęglanu sodu oraz suplementację wapnia i witaminy D. Regularne badania przesiewowe u osób z grup ryzyka (cukrzyca, nadciśnienie, wiek >60 lat, choroby sercowo-naczyniowe, wywiad rodzinny) oraz wczesne skierowanie do nefrologa przy spadku eGFR poniżej 30 ml/min/1,73 m² są niezbędne do spowolnienia progresji PChN i poprawy rokowania.

Zapobieganie schyłkowej niewydolności nerek

Schyłkowa niewydolność nerek (ESRD – End-Stage Renal Disease) to zaawansowane stadium przewlekłej choroby nerek, kiedy funkcja nerek nie jest już wystarczająca do przeżycia bez dializoterapii lub przeszczepienia nerki. Zapobieganie rozwojowi ESRD ma kluczowe znaczenie, ponieważ odpowiednio wczesne działania mogą znacząco opóźnić lub nawet zapobiec progresji do stadium schyłkowego, poprawiając jakość życia pacjentów i zmniejszając obciążenie systemu opieki zdrowotnej.¹²

Znaczenie profilaktyki w zapobieganiu ESRD

Przewlekła choroba nerek (PChN) staje się coraz poważniejszym problemem zdrowia publicznego na całym świecie. Przewiduje się, że do 2040 roku będzie piątą najczęstszą przyczyną utraty lat życia globalnie. Co istotne, początek i progresja PChN są często możliwe do zapobieżenia poprzez odpowiednie działania profilaktyczne.¹²

Wczesne wykrywanie jest kluczową strategią zapobiegania chorobom nerek, ich progresji i związanym z nimi powikłaniom. Niestety, liczne badania pokazują, że świadomość choroby nerek na poziomie populacyjnym jest niska. Dlatego zwiększanie wiedzy i wdrażanie zrównoważonych rozwiązań dla wczesnego wykrywania chorób nerek są priorytetami zdrowia publicznego.¹²

Choroba nerek może być wykryta wcześnie, a jej progresja do ESRD opóźniona dzięki odpowiedniemu dostępowi do podstawowej diagnostyki i wczesnemu leczeniu, w tym modyfikacjom stylu życia i interwencjom żywieniowym.¹

Strategie zapobiegania schyłkowej niewydolności nerek

Profilaktyka pierwotna

Profilaktyka pierwotna choroby nerek powinna koncentrować się na modyfikacji czynników ryzyka i eliminowaniu strukturalnych nieprawidłowości nerek i dróg moczowych, a także ograniczeniu ekspozycji na środowiskowe czynniki ryzyka i nefrotoksyny.¹²

Do głównych strategii profilaktyki pierwotnej należą:

Regularne badania kontrolne u osób z grupy ryzyka (cukrzyca, nadciśnienie, choroby sercowo-naczyniowe, wiek powyżej 60 lat, wywiad rodzinny chorób nerek)¹²
Kontrola cukrzycy – utrzymywanie poziomu glukozy we krwi w zakresie docelowym¹²
Kontrola nadciśnienia tętniczego – regularne pomiary i utrzymywanie ciśnienia w granicach prawidłowych¹²
Promowanie zdrowego stylu życia, w tym aktywności fizycznej i odpowiedniej diety¹²
Unikanie nefrotoksycznych leków, szczególnie niesteroidowych leków przeciwzapalnych (NLPZ)¹²
Ograniczenie spożycia alkoholu i zaprzestanie palenia tytoniu¹²

Profilaktyka wtórna

U osób z już istniejącą chorobą nerek, profilaktyka wtórna, w tym optymalizacja ciśnienia tętniczego i kontrola glikemii, powinna być głównym celem edukacji i interwencji klinicznych.¹²

Kluczowe działania w ramach profilaktyki wtórnej obejmują:

Stosowanie modulatorów szlaku angiotensyny, znanych również jako inhibitory układu renina-angiotensyna-aldosteron (RAASi), które stanowią podstawę farmakoterapii w profilaktyce wtórnej¹²
Kontrolę ciśnienia tętniczego – agresywna kontrola ciśnienia tętniczego może pomóc w opóźnieniu spadku funkcji nerek u pacjentów z PChN¹
Kontrolę glikemii u pacjentów z cukrzycą – ścisłe monitorowanie glukozy u pacjentów z ESRD i cukrzycą jest ważne, ponieważ zapotrzebowanie na insulinę jest trudne do przewidzenia, a ryzyko hipoglikemii jest zwiększone¹
Kontrolę profilu lipidowego – grupa robocza KDIGO zaleca, aby wszyscy dorośli z nowo zdiagnozowaną PChN przeszli badanie profilu lipidowego¹
Korektę kwasicy – korekcja kwasicy przy użyciu wodorowęglanu sodu jest związana ze znacznie wolniejszą progresją PChN¹
Stosowanie wapnia i witaminy D – rutynowe stosowanie wapnia i witaminy D jest zalecane u wszystkich pacjentów z PChN, nie tylko w celu utrzymania dobrego stanu kości, ale także w celu opóźnienia progresji choroby¹
Modyfikację diety – dieta roślinna opóźnia progresję do ESRD i dializ oraz potencjalnie poprawia przeżycie¹²

Profilaktyka trzeciorzędowa

U pacjentów z zaawansowaną PChN, leczenie współistniejących chorób, takich jak mocznica i choroby sercowo-naczyniowe, jest wysoce zalecaną interwencją zapobiegawczą, aby uniknąć lub opóźnić dializoterapię lub przeszczepienie nerki.¹²

Strategie profilaktyki trzeciorzędowej obejmują:

Wczesne skierowanie do nefrologa – wczesne skierowanie do specjalisty nefrologii pacjentów o zwiększonym ryzyku ESRD jest kluczowe, ponieważ wiąże się z poprawą wyników skoncentrowanych na pacjencie, w tym śmiertelności¹
Planowanie przeszczepienia nerki – kluczowym aspektem dla pacjentów z ESRD jest ustalenie kwalifikacji do przeszczepienia nerki, które w porównaniu z dializą lub leczeniem zachowawczym, poprawia przeżycie i jakość życia¹
Zarządzanie niedokrwistością i zaburzeniami elektrolitowymi, które często są wynikiem choroby nerek¹
Kompleksową opiekę nefrologiczną, w tym poradnictwo żywieniowe – osoby z ESRD są narażone na wysokie ryzyko rozwoju zespołu wyniszczenia białkowo-energetycznego i innych zaburzeń niedożywienia i powinny otrzymać poradę żywieniową od zarejestrowanego dietetyka¹
Wdrożenie szczepień ochronnych – ze względu na immunosupresję i zwiększoną podatność na infekcje u pacjentów z ESRD, Centra Kontroli i Zapobiegania Chorobom (CDC) zapewniają szczegółowe zalecenia dotyczące szczepień dla tej populacji¹²

Rola modyfikacji stylu życia w zapobieganiu ESRD

Kontrola diety

Odpowiednia dieta odgrywa kluczową rolę w zapobieganiu i leczeniu chorób nerek. Diety oparte na produktach roślinnych mają podwójną zaletę: dostarczają składników odżywczych i przeciwutleniaczy, które wspierają i potencjalnie leczą uszkodzone nerki, a jednocześnie eliminują przetworzone i zwierzęce pokarmy związane z większym ryzykiem PChN.¹

Zalecenia dietetyczne w profilaktyce ESRD obejmują:

Ograniczenie spożycia produktów z dodatkiem soli – zmniejszenie spożycia sodu poprzez unikanie produktów zawierających dodaną sól, takich jak żywność wygodna, zupy w puszkach i fast food. Słone przekąski, warzywa w puszkach, przetworzone mięso i sery również powinny być ograniczone¹²
Wybór produktów o niższej zawartości potasu – wybieranie produktów o niższej zawartości potasu podczas posiłków. Produkty o wysokiej zawartości potasu, takie jak banany, pomarańcze, ziemniaki, szpinak i pomidory, powinny być spożywane z umiarem. Lepiej wybierać alternatywy o niskiej zawartości potasu, takie jak jabłka, kapusta, marchew, fasolka szparagowa, winogrona i truskawki¹
Ograniczenie spożycia białka – kontrolowanie spożycia białka na podstawie dziennych gramów oszacowanych przez dietetyka. Źródła o wysokiej zawartości białka, takie jak chude mięso, jaja, mleko, ser i fasola, powinny być zrównoważone. Z kolei opcje o niskiej zawartości białka, takie jak warzywa, owoce, chleb i płatki zbożowe, są zalecane¹²
Zwiększenie spożycia owoców i warzyw – diety bogate w owoce i warzywa mogą zmniejszyć obciążenie kwasami w diecie i oferują ciekawe podejście do leczenia PChN poprzez zmniejszenie uszkodzeń nerek, spowolnienie progresji choroby i, co najważniejsze, pomoc pacjentom w poprawie jakości życia¹

Aktywność fizyczna

Regularna aktywność fizyczna jest niezbędna do utrzymania zdrowego ciśnienia krwi. Pomaga również kontrolować choroby przewlekłe, takie jak cukrzyca i choroby serca.¹

Zalecenia dotyczące aktywności fizycznej obejmują:

Podejmowanie co najmniej 30 minut intensywnej aktywności fizycznej dziennie, dążąc do utrzymania zdrowej wagi¹
Regularne ćwiczenia, takie jak pływanie, chodzenie i bieganie, które mogą pomóc zmniejszyć stres, kontrolować cukrzycę i wysokie ciśnienie krwi oraz utrzymać zdrową wagę¹
Unikanie siedzenia przez długi czas, co może przyczynić się do rozwoju chorób nerek¹

Unikanie czynników szkodliwych

Istnieją pewne czynniki, które mogą przyspieszyć rozwój choroby nerek. Ich ograniczenie lub eliminacja może znacząco przyczynić się do zapobiegania ESRD:

Zaprzestanie palenia tytoniu – palenie zmniejsza przepływ krwi do nerek. Uszkadza funkcję nerek u osób z chorobą nerek lub bez niej¹²
Ograniczenie spożycia alkoholu – nadmierne spożycie alkoholu może podnosić ciśnienie krwi. Dodatkowe kalorie w nim zawarte mogą również prowadzić do przyrostu masy ciała¹²
Ostrożne stosowanie leków przeciwbólowych dostępnych bez recepty – w dużych dawkach niesteroidowe leki przeciwzapalne (NLPZ), takie jak aspiryna, ibuprofen i naproksen, zmniejszają ilość przepływu krwi do nerek, co może im zaszkodzić¹²
Unikanie długotrwałej ekspozycji na metale ciężkie, takie jak ołów, paliwa, rozpuszczalniki i inne toksyczne chemikalia, które mogą przyczynić się do choroby nerek¹

Profilaktyka zakażeń u pacjentów z ESRD

Biorąc pod uwagę predyspozycję osób z PChN lub ESRD do rozwoju zakażeń bakteryjnych, które wiążą się z wysoką chorobowością i śmiertelnością w tej populacji, niezbędne są środki zapobiegawcze, aby zminimalizować zarówno ekspozycję, jak i późniejsze zakażenie.¹

Strategie profilaktyki zakażeń obejmują:

Szybkie leczenie uszkodzeń skóry lub ran, które powinno być tak samo szybkie, jak u osób z cukrzycą¹
Dążenie do wytworzenia dojrzałych przetok tętniczo-żylnych przed rozpoczęciem terapii nerkozastępczej¹
Eradykację kolonizacji wewnątrznosowej gronkowcem poprzez stosowanie maści przeciwbakteryjnych, takich jak mupirocyna stosowana dwa razy dziennie przez 5 dni, a następnie raz w tygodniu, co może pomóc zmniejszyć liczbę zakażeń gronkowcowych u pacjentów dializowanych¹
Stosowanie maści przeciwgronkowcowych lub przeciwbakteryjnych, takich jak mupirocyna lub gentamycyna, w miejscach wyjścia cewników dializacyjnych, co zmniejsza częstość występowania zakażeń i bakteriemii¹
Rozważenie podawania kwasu acetylosalicylowego, który może pomóc zapobiegać zakażeniom gronkowcowym u pacjentów z PChN lub ESRD¹
Ocenę stanu zdrowia jamy ustnej, która może być ważna dla utrzymania zdrowia u pacjentów z PChN lub ESRD i powinna być aktywnie zalecana¹
Profilaktykę antybiotykową przed inwazyjnymi zabiegami stomatologicznymi lub periodontologicznymi, która powinna być rozważona u pacjentów z PChN lub ESRD, którzy mają protezy zastawek lub wrodzone wady serca, oraz u osób z historią zapalenia wsierdzia lub przeszczepienia serca¹
Rozważenie podawania pojedynczej dawki doustnej amoksycyliny (2 g) lub pojedynczej dawki doustnej klindamycyny (600 mg) przed zabiegami stomatologicznymi pacjentom z cewnikami do hemodializy, którzy są narażeni na wysokie ryzyko rozwoju zapalenia wsierdzia, a którzy są uczuleni na penicylinę¹
Szczepienia przeciwko grypie i zakażeniom pneumokokowym, które mogą mieć charakter profilaktyczny i powinny być podawane, aby zapobiec powikłaniom chorobowym¹²

Profilaktyka powikłań sercowo-naczyniowych w ESRD

Pacjenci z ESRD są szczególnie narażeni na rozwój powikłań sercowo-naczyniowych, które mogą znacząco wpływać na ich rokowanie. Dlatego istotne jest wdrożenie odpowiednich strategii profilaktycznych:¹

Kontrola ciśnienia tętniczego – większość pacjentów poddawanych dializoterapii ma nadciśnienie tętnicze. Ponieważ kontrola ciśnienia krwi jest ściśle związana ze stanem objętościowym, modyfikacja sesji dializacyjnych w celu utrzymania normowolemii może poprawić kontrolę ciśnienia krwi¹
Utrzymywanie poziomu cholesterolu w zakresie docelowym, aby pomóc zapobiec zawałom serca i udarom¹
W przypadku migotania przedsionków, które jest ważną chorobą współistniejącą u pacjentów z ESRD poddawanych dializie, prowadzącą do zwiększonego wykorzystania opieki zdrowotnej, chorobowości i śmiertelności w tej już i tak obciążonej populacji, niezbędne jest odpowiednie podejście do profilaktyki udaru¹
Ze względu na zwiększone ryzyko krwawienia i zakrzepicy u pacjentów z ESRD i migotaniem przedsionków, środki niefarmakologiczne, takie jak zamknięcie uszka lewego przedsionka, stają się wysoce istotne w tej populacji¹

Znaczenie wczesnej diagnostyki i interwencji

Wczesne wykrycie i proaktywne zarządzanie są niezbędne, aby zapobiec rozwojowi schyłkowej niewydolności nerek. PChN może początkowo przebiegać bezobjawowo, a odpowiednie badania przesiewowe mogą pomóc w identyfikacji choroby na wczesnym etapie, kiedy interwencje mogą być najbardziej skuteczne.¹²

Kluczowe aspekty wczesnej diagnostyki i interwencji obejmują:

Regularne badania przesiewowe u osób z grupy ryzyka – jedynym sposobem, aby dowiedzieć się, jak dobrze funkcjonują twoje nerki, jest wykonanie badań. Badania są szczególnie ważne, jeśli masz cukrzycę, wysokie ciśnienie krwi lub choroby nerek w rodzinie¹
Wczesne skierowanie do nefrologa – pacjenci z przewlekłą chorobą nerek powinni być skierowani do nefrologa, jeśli ich szacunkowy GFR spadnie poniżej 30 ml na minutę na 1,73 m²¹
Cele wczesnego skierowania obejmują rozpoczęcie terapii specyficznych dla choroby; spowolnienie progresji przewlekłej choroby nerek; ocenę i leczenie chorób współistniejących i powikłań; zapewnienie wsparcia psychospołecznego; oraz planowanie przeszczepienia nerki, dializy lub zachowawczego leczenia nerek¹
Wykorzystanie kalkulatorów ryzyka do oszacowania ryzyka progresji do schyłkowej niewydolności nerek¹
Multidyscyplinarne zarządzanie pacjentami z PChN jest ważne dla zmniejszenia chorobowości i śmiertelności, a pacjenci z wysokim ryzykiem progresji do schyłkowej niewydolności nerek powinni być skierowani do nefrologa¹

Podejście globalne do zapobiegania ESRD

Zapobieganie ESRD wymaga skoordynowanych działań na poziomie globalnym, krajowym i lokalnym. Kluczowe jest zwiększanie świadomości społecznej, edukacja zdrowotna oraz wdrażanie odpowiednich polityk zdrowotnych.¹²

Globalne strategie zapobiegania ESRD obejmują:

Wzmocnienie poprzez edukację zdrowotną w celu rozwoju i wspierania krajowych kampanii, które podnoszą świadomość społeczną na temat zapobiegania chorobom nerek¹²
Podejścia populacyjne do zarządzania kluczowymi znanymi czynnikami ryzyka chorób nerek, takimi jak kontrola ciśnienia krwi i skuteczne zarządzanie otyłością i cukrzycą¹²
Wdrożenie podejścia Światowej Organizacji Zdrowia (WHO) Best Buys, obejmującego badania przesiewowe populacji zagrożonych PChN, powszechny dostęp do podstawowej diagnostyki wczesnej PChN, dostępność przystępnych cenowo podstawowych technologii i niezbędnych leków oraz przeniesienie zadań z lekarzy na pracowników podstawowej opieki zdrowotnej, aby skuteczniej ukierunkować progresję PChN i inne podejścia profilaktyczne drugiego stopnia¹²
Integrację profilaktyki PChN z programami dotyczącymi chorób niezakaźnych, która skutkuje zmniejszeniem ryzyka nerkowego i sercowo-naczyniowego w populacji ogólnej¹²
Rozwój programów edukacyjnych online dotyczących zapobiegania i leczenia chorób niezakaźnych, w tym PChN¹

Skuteczność działań profilaktycznych

Badania wskazują na skuteczność różnych działań profilaktycznych w zapobieganiu i opóźnianiu rozwoju ESRD. Niektóre z najlepiej udokumentowanych efektów obejmują:

Wczesna ocena programu CKDNET (Chronic Kidney Disease Prevention in the Northeast Thailand) po pierwszym roku wykazała, że program mógł spowolnić progresję choroby z 3 do 4 stadium o 20% i ze stadium 4 do 5 o 25%¹
Diety oparte na produktach roślinnych okazały się bezpieczne i użyteczne w zapobieganiu i leczeniu wszystkich chorób przewlekłych, w tym cukrzycy typu 2, otyłości, nadciśnienia i hiperlipidemii, które są częstymi chorobami współistniejącymi PChN¹
Osoby z cukrzycą mogą zapobiegać lub opóźniać PChN za pomocą leków obniżających ciśnienie krwi. Leki te zmniejszają ilość białka w moczu, czynnika ryzyka rozwoju PChN¹
Jeśli choroba zostanie wykryta wcześnie i odpowiednio leczona, tempo pogarszania się funkcji nerek można zmniejszyć nawet o 50%, a nawet odwrócić¹
Interdyscyplinarne zarządzanie pacjentami z PChN jest ważne dla zmniejszenia chorobowości i śmiertelności, a pacjenci z wysokim ryzykiem progresji do schyłkowej niewydolności nerek powinni być skierowani do nefrologa¹

Rola edukacji i świadomości społecznej

Edukacja zdrowotna i zwiększanie świadomości społecznej są kluczowymi elementami w zapobieganiu ESRD. Większość Amerykanów z chorobą nerek nie jest nawet świadoma, że ją ma. Wiedza o przyczynach chorób nerek i działaniach, które można podjąć, aby im zapobiec, może pomóc żyć lepszym życiem.¹

Strategie edukacyjne i uświadamiające obejmują:

Rozwój i wspieranie krajowych kampanii, które podnoszą świadomość społeczną na temat zapobiegania chorobom nerek¹
Edukację skoncentrowaną na pacjencie na temat znaczenia właściwego zarządzania chorobą, co może znacznie poprawić ogólną świadomość PChN i promować proaktywną interwencję u pacjentów z cukrzycą¹
Promocję i wdrażanie profilaktyki chorób nerek i niewydolności nerek wśród pracowników służby zdrowia, a także promocję profilaktyki z programami edukacyjnymi dla osób zagrożonych chorobami nerek i niewydolnością nerek oraz ogólnie dla całej populacji¹
Zadawanie kluczowych pytań dotyczących zdrowia nerek podczas kolejnej wizyty lekarskiej. Im wcześniej dowiesz się, że masz chorobę nerek, tym szybciej możesz rozpocząć leczenie, które pomoże chronić nerki¹

Podsumowanie strategii zapobiegania ESRD

Zapobieganie schyłkowej niewydolności nerek wymaga kompleksowego podejścia, obejmującego zarówno pierwotną, wtórną, jak i trzeciorzędową profilaktykę. Kluczowe strategie obejmują kontrolę czynników ryzyka, wczesne wykrywanie PChN, odpowiednie leczenie chorób podstawowych, modyfikacje stylu życia oraz edukację zdrowotną.¹²

Najskuteczniejsze strategie zapobiegania ESRD to:

Kontrola cukrzycy i nadciśnienia tętniczego – dwie główne przyczyny ESRD¹²
Regularne badania kontrolne u osób z grupy ryzyka¹²
Wczesne skierowanie do nefrologa¹
Modyfikacje stylu życia – zdrowa dieta, aktywność fizyczna, utrzymanie prawidłowej masy ciała¹²
Unikanie nefrotoksycznych czynników – NLPZ, tytoń, alkohol¹²
Odpowiednie leczenie farmakologiczne – inhibitory układu renina-angiotensyna-aldosteron (RAASi), leki kontrolujące glikemię, leki obniżające ciśnienie¹²
Edukacja zdrowotna i zwiększanie świadomości społecznej¹²

Najważniejsze jest zrozumienie, że schyłkowa niewydolność nerek to stan, któremu w wielu przypadkach można zapobiec lub opóźnić jego rozwój poprzez wczesną interwencję i odpowiednie postępowanie. Dzięki skoordynowanym wysiłkom na poziomie indywidualnym, klinicznym i systemowym, możliwe jest znaczące zmniejszenie globalnego obciążenia związanego z ESRD.¹²

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Materiały źródłowe

#1 Chronic kidney disease and the global public health agenda: an international consensus | Nature Reviews Nephrology
https://www.nature.com/articles/s41581-024-00820-6
Early detection is a key strategy to prevent kidney disease, its progression and related complications, but numerous studies show that awareness of kidney disease at the population level is low. […] Therefore, increasing knowledge and implementing sustainable solutions for early detection of kidney disease are public health priorities. […] This joint statement from the International Society of Nephrology, European Renal Association and American Society of Nephrology, supported by three other regional nephrology societies, advocates for the inclusion of kidney disease in the current WHO statement on major non-communicable disease drivers of premature mortality. […] Kidney disease is an increasing global problem that disproportionately affects poor, vulnerable and marginalized populations, and is associated with high individual, health care and societal costs.
#1
https://link.springer.com/article/10.1007/s00467-020-04604-5
The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. […] Crucially, however, the onset and progression of CKD are often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventionsbe it primary, secondary, or tertiary. […] Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. […] In patients with advanced CKD, the management of comorbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation.
#1
https://link.springer.com/article/10.1007/s00467-020-04604-5
Political efforts are needed to proliferate the preventive approach. […] Hence, there is an urgent need to increase awareness of the importance of preventive measures throughout populations, professionals, and policy makers. […] Importantly, however, kidney disease can be prevented and progression to ESRD can be delayed with appropriate access to basic diagnostics and early treatment including lifestyle modifications and nutritional interventions. […] Among measures to prevent emergence of de novo CKD are screening efforts to identify and manage persons at high risk of CKD, especially those with diabetes mellitus and hypertension. […] Promoting healthier lifestyle is an important means to that end including physical activity and healthier diet. […] The cornerstone of the pharmacotherapy in secondary prevention is the use of angiotensin pathway modulators, also known as renin-angiotensin-aldosterone system inhibitors (RAASi).
#1 Kidney Health for Everyone Everywhere – From prevention to detection and equitable access to care | NefrologÃa
https://revistanefrologia.com/en-kidney-health-for-everyone-everywhere-articulo-S201325142030047X
The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. […] Crucially, however, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions be it primary, secondary or tertiary. […] Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. […] In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions.
#1 End-Stage Renal Disease (ESRD) – Urology | UCLA Health
https://www.uclahealth.org/medical-services/urology/conditions-treated/adult-conditions/end-stage-renal-disease-esrd
End-stage renal disease (ESRD) occurs when the kidneys are no longer able to carry out their daily functions, requiring either dialysis or transplantation to sustain life. […] If the condition is detected and treated early and aggressively, many of these individuals can avoid complications, including progression to ESRD. […] The best strategy for preventing ESRD is to detect chronic kidney failure at the earliest possible stage so that the decline in kidney function can be slowed through the use of medications and tight control of blood sugar and blood pressure levels. Doctors can perform simple screening tests to check for certain protein levels in the urine and calculate kidney function based on creatinine levels in the blood. Routine screening is recommended for anyone over the age of 60 or who has diabetes, hypertension, and/or a family member with kidney disease.
#1 Preventing Chronic Kidney Disease – NIDDK
https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/prevention
You can protect your kidneys by preventing or managing health conditions that cause kidney damage, such as diabetes and high blood pressure. […] If you have diabetes, high blood pressure, or heart disease, the best way to protect your kidneys from damage is to […] Keep blood glucose numbers close to your goal. […] Keep your blood pressure numbers close to your goal. […] Take all your medicines as prescribed. […] To help prevent heart attacks and stroke, keep your cholesterol levels in the target range. […] Ask your health care provider the following key questions about your kidney health during your next medical visit. The sooner you know you have kidney disease, the sooner you can get treatment to help protect your kidneys.
#1 End-stage renal disease – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/end-stage-renal-disease/symptoms-causes/syc-20354532
If you have kidney disease, you may be able to slow its progress by making healthy lifestyle choices: […] Achieve and maintain a healthy weight […] Be active most days […] Limit protein and eat a balanced diet of nutritious, low-sodium foods […] Control your blood pressure […] Take your medications as prescribed […] Have your cholesterol levels checked every year […] Control your blood sugar level […] Don’t smoke or use tobacco products […] Get regular checkups.
#1 Kidney Health for Everyone Everywhere: From Prevention to Detection and Equitable Access to Care | Li | World Journal of Nephrology and Urology
https://wjnu.org/index.php/wjnu/article/view/402/336
In patients with advanced CKD, management of comorbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. […] Political efforts are needed to proliferate the preventive approach. […] Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals and policy makers. […] Importantly, however, kidney disease can be prevented and progression to ESRD can be delayed with appropriate access to basic diagnostics and early treatment including life style modifications and nutritional interventions. […] Among measures to prevent emergence of de novo CKD are screening efforts to identify and manage persons at high risk of CKD, especially those with diabetes mellitus and hypertension.
#1 Chronic Kidney Disease (CKD): Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/15096-chronic-kidney-disease
Seeing your healthcare provider on a regular basis throughout your life is a good start for preventing kidney disease. About 1 in every 3 people in the United States is at risk for kidney disease. People at high risk may have regular tests to check for CKD so its detected as early as possible. Some other things you can do to prevent CKD are: […] Manage your high blood pressure. […] Manage your blood sugar if you have diabetes. […] Eat a well-balanced diet. […] Don’t smoke or use tobacco. […] Be active for 30 minutes at least five days a week. […] Maintain a healthy weight. […] Take nonprescription pain relievers only as directed. Taking more than directed can damage your kidneys. […] Limit alcohol-containing beverages.
#1 Kidney disease prevention
https://www.kidneyfund.org/all-about-kidneys/kidney-disease-prevention
Most Americans with kidney disease are not even aware they have it. […] Knowing what causes kidney disease and knowing what actions you can take to prevent it can help you live your best life. […] Eating foods that are low in sodium (salt) and fat can help keep your kidneys healthy. […] Following an eating plan that is low in added sugar can help prevent heart disease, manage diabetes and help maintain a healthy weight. These are all important factors when managing or preventing chronic kidney disease (CKD). […] Being active can keep your kidneys healthy by helping you: Stay at a healthy weight. […] Drinking too much alcohol can make your blood pressure go up, which in time can lead to kidney disease. […] Using tobacco (smoking or chewing) can make your blood pressure go up, which in time can lead to kidney disease.
#1 Chronic Kidney Disease (CKD) prevention | Africa Health Organisation
https://aho.org/news/chronic-kidney-disease-prevention/
Adopting below measures can surely prevent the progression of chronic kidney disease and prolong the renal function and thus avoid early need for renal replacement therapy. […] Although itâs scary for a person to be diagnosed with chronic kidney disease but even if someone is diagnosed in early-stage CKD (stage 1-3), there are many steps a person can take to preserve the existing renal function and delay the further loss of renal function. […] Once a person develops CKD, there are actions an individual can take to prolong kidney function. This includes treatment of the underlying conditions i.e. control of diabetes, hypertension and proteinuria, avoidance of nephrotoxic drugs, dietary and lifestyle changes like stopping smoking & regular exercise. […] Aggressive blood pressure control can help in delaying the decline in renal function in patients with CKD.
#1 End-Stage Renal Disease: Medical Management | AAFP
https://www.aafp.org/pubs/afp/issues/2021/1100/p493.html
People with ESRD are at high risk of developing protein-energy wasting and other malnutrition disorders and should receive nutritional counseling from a registered dietitian. […] Most patients receiving dialysis have hypertension. Because blood pressure control is closely associated with volume status, modifying dialysis sessions to maintain normovolemia can improve blood pressure control. […] Careful glucose monitoring in patients with ESRD and diabetes is important because insulin requirements are difficult to predict and the risk of hypoglycemia is increased in these patients.
#1 Chronic Kidney Disease (CKD) prevention | Africa Health Organisation
https://aho.org/news/chronic-kidney-disease-prevention/
Routine use of calcium and vit D is recommended in all CKD patients not only for maintaining good bone health but also to delay progression of the disease. […] A great number of individuals with CKD may be unaware of their disease and thus may be at risk for further kidney injury through use of NSAIDs. […] Correction of acidosis with sodium bicarbonate is associated with significantly slower progression of CKD. […] Improving Global Outcomes (KDIGO) workgroup recommend that all adults with newly diagnosed CKD should undergo lipid profile testing. […] Plant-based diets delays progression to ESRD and dialysis and potentially improves survival. […] The Modification of Diet in Renal Disease (MDRD) Study suggested that a low-protein diet slows down the GFR decline and reduces proteinuria. […] Reduction in salt intake slows the progression of diabetic CKD by lowering blood pressure. […] Smoking should be strictly avoided as this decreases the risk for future onset of kidney failure.
#1 Kidney Health for Everyone Everywhere – From prevention to detection and equitable access to care | NefrologÃa
https://revistanefrologia.com/en-kidney-health-for-everyone-everywhere-articulo-S201325142030047X
In patients with advanced CKD, management of co-morbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. […] Political efforts are needed to proliferate the preventive approach. […] Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals and policy makers. […] Measures to achieve effective primary prevention should focus on the two leading risk factors for CKD including diabetes mellitus and hypertension. […] Among measures to prevent emergence of de novo CKD are screening efforts to identify and manage persons at high risk of CKD, especially those with diabetes mellitus and hypertension. […] The cornerstone of the pharmacotherapy in secondary prevention is the use of angiotensin pathway modulators, also known as reninangiotensinaldosterone system inhibitors (RAASi).
#1 End-Stage Renal Disease: Medical Management | AAFP
https://www.aafp.org/pubs/afp/issues/2021/1100/p493.html
End-stage renal disease (ESRD) is diagnosed when kidney function is no longer adequate for long-term survival without kidney transplantation or dialysis. Primary care clinicians should refer people at risk of ESRD to nephrology to optimize disease management. […] Early nephrology referral for patients at increased risk of ESRD is vital because it is associated with improved patient-centered outcomes, including mortality. […] Patients with chronic kidney disease should be referred to nephrology if their estimated GFR falls below 30 mL per minute per 1.73 m2. […] Goals of early referral include initiating disease-specific therapies; slowing the progression of chronic kidney disease; evaluating and treating comorbid conditions and complications; providing psychosocial support; and planning for kidney transplantation, dialysis, or conservative kidney management.
#1 End-Stage Renal Disease: Medical Management | AAFP
https://www.aafp.org/pubs/afp/issues/2021/1100/p493.html
A key consideration for patients with ESRD is establishing eligibility for kidney transplantation, which, compared with dialysis or conservative management, improves survival and quality of life. […] Most patients elect to receive dialysis to treat their ESRD, and these patients tend to live longer than those choosing conservative management. […] Patients with ESRD can elect a palliative approach to managing their disease that does not involve dialysis. This approach emphasizes quality of life over the prolongation of life. […] Because of immune suppression and increased susceptibility to infection in patients with ESRD, the Centers for Disease Control and Prevention (CDC) provides specific vaccination recommendations for this population. […] Given the limited life expectancy for most patients with ESRD who do not undergo kidney transplantation, routine cancer screening is discouraged in these patients.
#1
https://health.maryland.gov/phpa/ccdb/Pages/Chronic-Kidney-Disease-Prevention-(CKD)-Fact-Sheet.aspx
Chronic Kidney Disease (CKD) is a condition where the kidneys cannot filter blood as they should. They slowly lose their ability to filter wastes, fluids, and electrolytes from the body. This causes excess fluid and waste to remain in the body which can cause other health conditions such as: […] If you have any of the CKD risk factors, talk to your healthcare provider about your kidney health and other steps at your next visit. […] Early detection and management of kidney disease can slow or delay the need for end stage treatments. […] For patients with early-stage, stage 1-3, treatments often focus on lifestyle change and managing related conditions such as diabetes and high blood pressure. […] For more advanced kidney disease, stage 4, treating anemia and electrolyte disorders, which are often the result of kidney disease, is often required. […] For kidney failure, stage 5, dialysis or transplant is necessary.
#1 The Benefits of Plant-Based Nutrition: Treatment and Prevention of Chronic Kidney Diseaseâ¯ – American College of Lifestyle Medicine
https://lifestylemedicine.org/articles/benefits-plant-based-nutrition-chronic-kidney-disease/
Whole food, plant-based diets offer two advantages for prevention and treatment of CKD. First, higher consumption of plant foods are protective against the disease; second, lower consumption of animal and higher protein foods reduce renal burden. […] Plant-based diets are the key to controlling acid load to keep metabolic acidosis in check and thus slow progression of kidney disease. […] Whole food, plant-based diets have the dual advantages of supplying nutrients and antioxidants that support and potentially heal damaged kidneys and eliminate the processed and animal foods associated with greater risk for CKD. […] Studies indicate that the benefits of plant-based diets can be applied to all populations to address kidney dysfunction, even in the elderly at advanced stages. Plant-based diets have been demonstrated to be safe and useful in preventing and treating all chronic diseases, including type 2 diabetes, obesity, hypertension, and hyperlipidemia, which are common comorbidities of CKD. The utility of plant-based diets for CKD has become increasingly apparent. […] Overall, existing evidence indicates that diets rich in fruits and vegetables can reduce the dietary acid load and offer an exciting approach to treating CKD by reducing kidney damage, slowing disease progression, and, most importantly, helping patients improve their quality of life.
#1 End stage renal disease (ESRD) – Kidney Care Center
https://kidneycares.com/end-stage-renal-disease-esrd/
As part of your kidney disease treatment, your healthcare provider might suggest a specialized diet to ease the strain on your kidneys and support their function. Consulting a registered dietitian with expertise in kidney disease can provide insight into modifying your diet for kidney health. Based on your circumstances, kidney function, and overall well-being, your dietitian may recommend the following: […] Avoid products with added salt. Reducing sodium intake by avoiding products containing added salt, such as convenience foods, canned soups, and fast food. Salted snacks, canned vegetables, processed meats, and cheeses should also be limited. […] Choose lower potassium foods. Choosing lower-potassium foods during meals. High-potassium foods like bananas, oranges, potatoes, spinach, and tomatoes should be moderated. Opt for low-potassium alternatives like apples, cabbage, carrots, green beans, grapes, and strawberries. Be cautious of salt substitutes containing potassium, which are generally unsuitable for individuals with kidney failure. […] Limit your protein. Controlling protein consumption based on the daily grams estimated by your dietitian. High-protein sources like lean meats, eggs, milk, cheese, and beans should be balanced. Conversely, low-protein options like vegetables, fruits, bread, and cereals are encouraged.
#1 Chronic kidney disease: Symptoms, stage, treatment, and more
https://www.medicalnewstoday.com/articles/172179
People who are at high risk of developing CKD should have regular kidney function checks. Early detection can help prevent severe kidney damage. […] It is essential that people receive an early diagnosis of and prompt treatment for kidney disease to prevent serious damage. […] Some conditions, such as diabetes, increase the risk of CKD. Controlling diabetes can reduce the risk of developing kidney failure. Individuals should follow their doctors instructions, advice, and recommendations. […] Eating a healthy diet can help a person lower their blood pressure. […] Getting regular physical activity is ideal for maintaining healthy blood pressure levels. It also helps control chronic conditions, such as diabetes and heart disease. […] Excessive alcohol and drug use, as well as long-term exposure to heavy metals such as lead, fuels, solvents, and other toxic chemicals can contribute to kidney disease.
#1 Kidney failure – End-Stage Renal Disease: Symptoms, Causes & Treatment Your Webpage TitlePACE Hospitals – Best Hospitals in Hitech City, Hyderabad, India | Near Madhapur, Kukatpally, KPHB, Kondapur, Gachibowli, Jubilee Hills, Banjara Hill
https://www.pacehospital.com/kidney-failure-end-stage-renal-disease-symptoms-causes-treatment
Kidney failure prevention starts with avoiding contracting AKI or CKD. Nevertheless, the prevention of kidney failure can be initiated if the treatment strategies which are effective in slowing the progression toward kidney failure are started at earlier stages of CKD. […] Avoiding or managing diabetes, hypertension, and other such health issues that cause kidney damage is the primary step in preventing kidney failure. Maintaining a healthy weight with healthy food and exercise helps both kidney failure patients as well as the risk population. […] Other kidney failure prevention tips include: Taking at least 30 minutes of rigorous physical activity daily, aiming for a healthy weight. Getting enough sleep (at least 7-8 hours each night). Abstaining from smoking and other tobacco product consumption. Limiting alcohol intake, thus avoiding weight gain. Exploring stress-reducing activities and sticking one (such as yoga) suiting your needs helps in relaxation and coping with emotional and physical health problems.
#1 11 Tips to Prevent Kidney Failure, Treatment Options & More
https://www.healthline.com/health/kidney-health/how-to-prevent-kidney-failure
Dehydration reduces blood flow to your kidneys, which can damage them. Ask your doctor how much water you should drink per day. […] Alcohol increases your blood pressure. The extra calories in it can make you gain weight, too. […] Smoking reduces blood flow to your kidneys. It damages kidney function in people with or without kidney disease. […] In high doses, nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen, reduce the amount of blood flow to your kidneys, which can harm them. […] Reducing stress and anxiety can lower your blood pressure, which is good for your kidneys. […] Exercise, such as swimming, walking, and running, can help reduce stress, manage diabetes and high blood pressure, and maintain a healthy weight. […] Following these tips can help you prevent kidney failure or slow its progression. The most important thing you can do is manage your diabetes and high blood pressure. […] Living a healthy lifestyle by eating right, being active, and not smoking is another key to keeping your kidneys healthy.
#1 End stage renal disease: Symptoms, life expectancy, and more
https://www.medicalnewstoday.com/articles/end-stage-renal-disease
In some cases, there is no way to prevent kidney failure. This is the case when it is due to a genetic condition or malformation, injury, or infection. […] That said, the best way to prevent ESRD is to follow lifestyle and dietary habits that reduce the risk of developing the two leading causes of ESRD, diabetes and high blood pressure. […] For example, a person could try: maintaining a moderate body weight, eating a healthy, balanced diet, reducing their intake of saturated fat, avoiding or limiting alcohol consumption, avoiding or limiting their intake of sweetened foods and drinks, reducing their intake of processed or heavily refined foods, getting enough exercise and sleep each day, staying hydrated, managing or reducing stress, avoiding sitting for prolonged periods of time.
#1 Preventive Health Care in CKD and End-stage Renal Disease
https://www.medscape.org/viewarticle/570239_3
Given the predisposition of people with CKD or ESRD to developing bacterial infections, which are associated with high morbidity and mortality in this population, preventive measures are necessary to minimize both exposure and subsequent infection. […] Treatment of skin breakdown or wounds needs to be as prompt as it is for people with diabetes. […] Every effort should be made to establish mature arteriovenous fistulas before initiation of renal replacement therapy. […] Eradication of intranasal staphylococcal colonization by the use of antibacterial ointments, such as mupirocin applied twice daily for 5 days and once per week thereafter, can help to reduce the number of staphylococcal infections in dialysis patients. […] Applying antistaphylococcal or antibacterial ointments, such as mupirocin or gentamicin, at the exit sites of dialysis catheters decreases rates of infection and bacteremia.
#1 Preventive Health Care in CKD and End-stage Renal Disease
https://www.medscape.org/viewarticle/570239_3
Daily aspirin therapy could help to prevent staphylococcal infection in patients with CKD or ESRD. […] Evaluation of oral health can be important for health maintenance in patients with CKD or ESRD and should be actively encouraged. […] Antibiotic prophylaxis before invasive dental or periodontal procedures should be considered for patients with CKD or ESRD who have prosthetic valves or congenital cardiac defects and those with a history of endocarditis or cardiac transplantation. […] Patients with hemodialysis catheters are at high risk of developing endocarditis; administration of single-dose oral amoxicillin (2 g) or single dose oral clindamycin (600 mg) before dental procedures should be considered for those who are allergic to penicillin. […] In light of the increased risk of pulmonary infection that is associated with CKD and ESRD, influenza and pneumococcal vaccinations can be preventive and should be administered to preclude morbid complications.
#1
https://www.nhs.uk/conditions/kidney-disease/
You can help prevent CKD by making healthy lifestyle changes and ensuring any underlying conditions you have are well controlled. […] Cardiovascular disease is one of the main causes of death in people with kidney disease, although healthy lifestyle changes and medicine can help reduce your risk of developing it.
#1 Stroke Prophylaxis in Patients with Atrial Fibrillation and End-Stage Renal Disease
https://www.mdpi.com/2077-0383/9/1/123
Atrial fibrillation (AF) is an important comorbidity in patients with end-stage renal disease (ESRD) undergoing dialysis that portends increased health care utilization, morbidity, and mortality in this already high-risk population. […] The ESRD population presents a unique challenge because of the combination of elevated stroke and bleeding risks. […] Despite ongoing efforts to address these alarming outcomes, the best approach for stroke prevention in AF in the setting of ESRD remains controversial. […] The desire to provide a net benefit in the face of a delicate balance of both increased bleeding and thrombotic risk sets the ESRD AF population apart from the average AF population with regards to the use of systemic anticoagulation. […] Patients with ESRD have an increased risk of bleeding as discussed above, and systemic anticoagulation may not be the ideal approach for stroke prevention in ESRD AF patients regardless of the agent used, especially in those with a history of major bleeding.
#1 Stroke Prophylaxis in Patients with Atrial Fibrillation and End-Stage Renal Disease
https://www.mdpi.com/2077-0383/9/1/123
Non-pharmacological measures for stroke prophylaxis become highly relevant in this population. […] Current guidelines do not specifically address LAA occlusion or non-pharmacologic stroke prevention in ESRD AF. […] The best approach for stroke prevention in this highly complex and co-morbid population requires further assessment in prospective studies.
#1 Chronic Kidney Disease Prevention Made Easy: Insurance-Covered Nutrition Therapy in WV
https://www.qualityinsights.org/quality-quest/west-virginia-ckd-prevention-program-connect-with-insurance-covered-registered-dietitians
Chronic kidney disease (CKD) affects many West Virginians, often remaining unnoticed until it has advanced. […] The program provides West Virginians with access to insurance-covered registered dietitian services, offering personalized nutrition therapy to help manage CKD and related conditions like diabetes and hypertension. […] Early detection and proactive management are essential to prevent the condition from advancing. […] The program helps prevent the progression of CKD, improves health outcomes, and enhances the quality of life for West Virginians managing CKD.
#1 Kidney disease prevention
https://www.kidneyfund.org/all-about-kidneys/kidney-disease-prevention
Quitting can help lower your chance of getting kidney disease or help prevent your kidney disease from getting worse. […] The only way to know how well your kidneys are working is to get tested. Testing is especially important if you have diabetes, high blood pressure or a family history of kidney disease. […] Be proactive in knowing about your kidneys and ways to protect them. No one should be more invested in protecting them than you!
#1 Chronic Kidney Disease: Prevention, Diagnosis, and Treatment | AAFP
https://www.aafp.org/pubs/afp/issues/2023/1200/chronic-kidney-disease.html
Chronic kidney disease (CKD) affects approximately 15% of the U.S. population, and many people are unaware of their diagnosis. Screening may be considered for patients with cardiovascular disease, diabetes mellitus, hypertension, age 60 years and older, family history of kidney disease, previous acute kidney injury, or preeclampsia. […] Risk calculators are available to estimate the risk of progression to end-stage renal disease. […] Interdisciplinary management of patients with CKD is important for reducing morbidity and mortality, and patients at high risk of progression to end-stage renal disease should be referred to a nephrologist.
#1 Kidney Health for Everyone Everywhere – From prevention to detection and equitable access to care | NefrologÃa
https://revistanefrologia.com/en-kidney-health-for-everyone-everywhere-articulo-S201325142030047X
Detection and prevention of CKD programs require considerable resources both in terms of manpower and funds. […] The role of primary healthcare professionals in the implementation of CKD prevention strategies in LMIC countries has been recently illustrated. […] Online learning programs for NCD prevention and treatment, including CKD, have been successfully implemented in Mexico. […] Given the pressing urgency pertaining to the need for increasing education and awareness on the importance of the preventive measures, we suggest the following goals to redirect the focus on plans and actions: Empowerment through health literacy in order to develop and support national campaigns that bring public awareness to prevention of kidney disease. […] Population-based approaches to manage key known risks for kidney disease, such as blood pressure control and effective management of obesity and diabetes.
#1 Kidney Health for Everyone Everywhere: From Prevention to Detection and Equitable Access to Care | Li | World Journal of Nephrology and Urology
https://wjnu.org/index.php/wjnu/article/view/402/336
Given the pressing urgency pertaining to the need for increasing education and awareness on the importance of the preventive measures, we suggest the following goals to redirect the focus on plans and actions: 1) Empowerment through health literacy in order to develop and support national campaigns that bring public awareness to prevention of kidney disease; 2) Population-based approaches to manage key known risks for kidney disease, such as blood pressure control and effective management of obesity and diabetes; 3) Implementation of the World Health Organization (WHO) Best Buys approach including screening of at-risk populations for CKD, universal access to essential diagnostics of early CKD, availability of affordable basic technologies and essential medicines and task shifting from doctors to front-line healthcare workers to more effectively target progression of CKD and other secondary preventative approaches.
#1 Kidney Health for Everyone Everywhere: From Prevention to Detection and Equitable Access to Care | Li | World Journal of Nephrology and Urology
https://wjnu.org/index.php/wjnu/article/view/402/336
Promoting healthier lifestyle is an important means to that end including physical activity and healthier diet. […] The cornerstone of the pharmacotherapy in secondary prevention is the use of angiotensin pathway modulators, also known as renin-angiotensin-aldosterone system inhibitors (RAASi). […] In patients with advanced CKD, management of uremia and related comorbid conditions such as anemia, mineral and bone disorders, and cardiovascular disease is of high priority, so that these patients can continue to achieve highest longevity. […] The integration of CKD prevention into NCDs program has resulted in the reduction of renal and cardiovascular risks in the general population. […] The approach towards CKD early detection will include the decision for frequency of screening, who should perform the screening, and intervention after screening.
#1 CKDNET, a quality improvement project for prevention and reduction of chronic kidney disease in the Northeast Thailand | BMC Public Health | Full Text
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09387-w
Comprehensive CKD care of the CKDNET is being provided by the formulation of local guidelines and creation of an alert list based on the patients EMR in the CKDNET registry. […] Our compliance improvement strategy using case-manager nurses showed high impact on management and care of CKD patients. […] The early assessment of the CKDNET program on patient outcomes at the first year revealed that the program could slow the disease progression from stages 3 to 4 by 20% and stages 4 to 5 by 25%. […] The CKDNET project has outlined and instigated prolific strategies for prevention and management of CKD in the Northeast of Thailand.
#1 Preventing Chronic Kidney Disease | Chronic Kidney Disease | CDC
https://www.cdc.gov/kidney-disease/prevention/index.html
Managing risk factors like diabetes and high blood pressure can help prevent kidney problems like chronic kidney disease (CKD). […] People who have diabetes may be able to prevent or delay CKD with blood pressure-lowering drugs. These medicines reduce protein in the urine, a risk factor for developing CKD. […] The earlier you take action to prevent or delay kidney disease, the better. […] Take action to prevent, delay, or manage CKD: […] If you have diabetes, get tested yearly. […] If you have high blood pressure: Check it regularly and get it under control to protect your kidneys.
#1
https://journals.lww.com/jfmpc/fulltext/2020/09080/chronic_kidney_diseases__a_realm_for_preventive.4.aspx
These simple measures will slow down the progression of kidney disease, prevent complications and thereby improve the QOL. […] So, prevention of CKD and halting its progression to ESRD becomes the cornerstone for providing the most cost-effective care. […] This can start with the screening and detection of a silent disease, which gives years of opportunity for discovery and modification of its natural history. […] It is crucial to promote Prevention of Kidney diseases with specific educational programs especially for those at risk of kidney disease. […] If detected early and managed appropriately, the rate of deterioration in kidney function can be reduced by as much as 50%, and may even be reversible. […] Preventive nephrology is still important in higher stages of CKD stage 3 and above.
#1 Diabetic Kidney Disease: Goals for Management, Prevention, and Awareness
https://www.mdpi.com/2673-8392/3/3/83
This entry will review the current preventative approach for DKD, including strict glycemic control, treatment of hypertension and hyperlipidemia, promotion of patient-driven lifestyle modifications, and incorporation of point-of care patient education. […] In summary, individualized dietary and exercise modifications, as well as smoking cessation are all non-invasive, non-pharmacological therapies and should be considered an important factor in DKD prevention and management. […] Patient-centered education on the importance of proper disease management could greatly improve general awareness of DKD and promote proactive intervention in diabetes patients. […] A thorough preventive approach for DKD includes glycemic control, treatment of hypertension and hyperlipidemia co-morbidities, and lifestyle modifications (diet, exercise, and smoking cessation).
#1
https://link.springer.com/article/10.1007/s00467-020-04604-5
The role of primary healthcare professionals in the implementation of CKD prevention strategies in LMIC countries has been recently illustrated. […] It is important to enhance the promotion and implementation of Prevention of kidney disease and kidney failure amongst healthcare professionals, it is equally important to promote Prevention with education programs for those at risk of kidney disease and kidney failure, and with the general population at large. […] Given the pressing urgency pertaining to the need for increasing education and awareness on the importance of the preventive measures, we suggest the following goals to redirect the focus on plans and actions: Empowerment through health literacy in order to develop and support national campaigns that bring public awareness to prevention of kidney disease.
#1
https://journals.lww.com/jfmpc/fulltext/2020/09080/chronic_kidney_diseases__a_realm_for_preventive.4.aspx
Chronic Kidney Disease (CKD) is emerging as a major public health priority worldwide. Preventive measures focusing on reducing the prevalence of CKD by limiting exposure to risk factors could be cost effective in a country like India. […] The management of patients with CKD is focused on early detection or prevention, treatment of the underlying cause (if possible) to curb progression and attention to secondary processes that contribute to ongoing nephron loss. […] Focusing on limiting exposure to risk factors of CKD could be the most cost-effective preventive measure for a developing country like India. […] If detected well in time, patients’ progress to kidney failure can be halted. […] Prevention of ESRD will involve principles of both primary and secondary prevention, i.e., early identification of kidney disease and its risk factors, prompt treatment of the amenable abnormalities, and halt the progression to renal failure.
#1 11 Tips to Prevent Kidney Failure, Treatment Options & More
https://www.healthline.com/health/kidney-health/how-to-prevent-kidney-failure
Reducing stress and anxiety can lower your blood pressure, which is good for your kidneys. […] Because high blood pressure and diabetes are the most common causes of kidney failure, many of the prevention tips are related to managing these two conditions. […] Diabetes increases your risk for heart disease and kidney failure. Thats just one reason to manage your blood sugar. […] High blood pressure can increase your risk for heart disease as well as kidney failure. […] Obesity can increase your risk for conditions associated with kidney failure, such as diabetes and high blood pressure. […] A heart-healthy diet one low in sugar and cholesterol and high in fiber, whole grains, and fruits and vegetables helps prevent weight gain. […] Eating too much salt is associated with high blood pressure.
#2
https://journals.lww.com/jfmpc/fulltext/2020/09080/chronic_kidney_diseases__a_realm_for_preventive.4.aspx
Chronic Kidney Disease (CKD) is emerging as a major public health priority worldwide. Preventive measures focusing on reducing the prevalence of CKD by limiting exposure to risk factors could be cost effective in a country like India. […] The management of patients with CKD is focused on early detection or prevention, treatment of the underlying cause (if possible) to curb progression and attention to secondary processes that contribute to ongoing nephron loss. […] Focusing on limiting exposure to risk factors of CKD could be the most cost-effective preventive measure for a developing country like India. […] If detected well in time, patients’ progress to kidney failure can be halted. […] Prevention of ESRD will involve principles of both primary and secondary prevention, i.e., early identification of kidney disease and its risk factors, prompt treatment of the amenable abnormalities, and halt the progression to renal failure.
#2 Kidney Health for Everyone Everywhere – From prevention to detection and equitable access to care | NefrologÃa
https://revistanefrologia.com/en-kidney-health-for-everyone-everywhere-articulo-S201325142030047X
The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. […] Crucially, however, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions be it primary, secondary or tertiary. […] Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. […] In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions.
#2 Kidney disease prevention
https://www.kidneyfund.org/all-about-kidneys/kidney-disease-prevention
Most Americans with kidney disease are not even aware they have it. […] Knowing what causes kidney disease and knowing what actions you can take to prevent it can help you live your best life. […] Eating foods that are low in sodium (salt) and fat can help keep your kidneys healthy. […] Following an eating plan that is low in added sugar can help prevent heart disease, manage diabetes and help maintain a healthy weight. These are all important factors when managing or preventing chronic kidney disease (CKD). […] Being active can keep your kidneys healthy by helping you: Stay at a healthy weight. […] Drinking too much alcohol can make your blood pressure go up, which in time can lead to kidney disease. […] Using tobacco (smoking or chewing) can make your blood pressure go up, which in time can lead to kidney disease.
#2 Kidney Health for Everyone Everywhere: From Prevention to Detection and Equitable Access to Care | Li | World Journal of Nephrology and Urology
https://wjnu.org/index.php/wjnu/article/view/402/336
The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the fifth most common cause of years of life lost globally by 2040. […] Crucially, however, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions: be it primary, secondary or tertiary. […] Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. […] In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions.
#2 Preventing Chronic Kidney Disease | Chronic Kidney Disease | CDC
https://www.cdc.gov/kidney-disease/prevention/index.html
Managing risk factors like diabetes and high blood pressure can help prevent kidney problems like chronic kidney disease (CKD). […] People who have diabetes may be able to prevent or delay CKD with blood pressure-lowering drugs. These medicines reduce protein in the urine, a risk factor for developing CKD. […] The earlier you take action to prevent or delay kidney disease, the better. […] Take action to prevent, delay, or manage CKD: […] If you have diabetes, get tested yearly. […] If you have high blood pressure: Check it regularly and get it under control to protect your kidneys.
#2 What doctors wish patients knew about kidney disease prevention | American Medical Association
https://www.ama-assn.org/delivering-care/hypertension/what-doctors-wish-patients-knew-about-kidney-disease-prevention
Even though human kidneys are just the size of a computer mouse, they are critical for maintaining good healthfiltering blood in the body every 30 minutes, working hard to remove waste, toxins and excess fluid, as well as helping to control blood pressure. […] There is good news, though. Kidney disease can be prevented, and even reversed in its early stages. […] The biggest risk factors are if you have high blood pressure or diabetes mellitus. Those are the main conditions that can lead to chronic kidney disease when uncontrolled, Dr. Correa said. […] If you have diabetes, it is important to control your diabetes. If not, you are going down a path that 10- 15 years later you are going to be on dialysis, Dr. Correa said, noting that includes keeping blood-glucose numbers close to your goal by checking your levels.
#2 Chronic Kidney Disease (CKD): Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/15096-chronic-kidney-disease
Seeing your healthcare provider on a regular basis throughout your life is a good start for preventing kidney disease. About 1 in every 3 people in the United States is at risk for kidney disease. People at high risk may have regular tests to check for CKD so its detected as early as possible. Some other things you can do to prevent CKD are: […] Manage your high blood pressure. […] Manage your blood sugar if you have diabetes. […] Eat a well-balanced diet. […] Don’t smoke or use tobacco. […] Be active for 30 minutes at least five days a week. […] Maintain a healthy weight. […] Take nonprescription pain relievers only as directed. Taking more than directed can damage your kidneys. […] Limit alcohol-containing beverages.
#2 End stage renal disease: Symptoms, life expectancy, and more
https://www.medicalnewstoday.com/articles/end-stage-renal-disease
In some cases, there is no way to prevent kidney failure. This is the case when it is due to a genetic condition or malformation, injury, or infection. […] That said, the best way to prevent ESRD is to follow lifestyle and dietary habits that reduce the risk of developing the two leading causes of ESRD, diabetes and high blood pressure. […] For example, a person could try: maintaining a moderate body weight, eating a healthy, balanced diet, reducing their intake of saturated fat, avoiding or limiting alcohol consumption, avoiding or limiting their intake of sweetened foods and drinks, reducing their intake of processed or heavily refined foods, getting enough exercise and sleep each day, staying hydrated, managing or reducing stress, avoiding sitting for prolonged periods of time.
#2 End-Stage Renal Disease Guide: Causes, Symptoms and Treatment Options
https://www.drugs.com/health-guide/end-stage-renal-disease.html
You can take steps to reduce your risk of developing end-stage renal disease: […] If you have diabetes, control your blood sugar. […] Closely monitor and aggressively treat high blood pressure. High blood pressure further damages the kidneys in people with kidney disease. […] If you have kidney disease, avoid over the counter arthritis medicines. Non-steroidal anti-inflammatory drugs (NSAIDs) can cause kidney damage. […] Talk with your doctor about medication to slow the progression of chronic kidney disease. Your doctor may recommend an SGLT2 inhibitor, such as canagliflozin (Invokana), dapagliflozin (Farxiga) and empagliflozin (Jardiance). […] Quitting smoking and lowering cholesterol levels may also help.
#2 11 Tips to Prevent Kidney Failure, Treatment Options & More
https://www.healthline.com/health/kidney-health/how-to-prevent-kidney-failure
Dehydration reduces blood flow to your kidneys, which can damage them. Ask your doctor how much water you should drink per day. […] Alcohol increases your blood pressure. The extra calories in it can make you gain weight, too. […] Smoking reduces blood flow to your kidneys. It damages kidney function in people with or without kidney disease. […] In high doses, nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen, reduce the amount of blood flow to your kidneys, which can harm them. […] Reducing stress and anxiety can lower your blood pressure, which is good for your kidneys. […] Exercise, such as swimming, walking, and running, can help reduce stress, manage diabetes and high blood pressure, and maintain a healthy weight. […] Following these tips can help you prevent kidney failure or slow its progression. The most important thing you can do is manage your diabetes and high blood pressure. […] Living a healthy lifestyle by eating right, being active, and not smoking is another key to keeping your kidneys healthy.
#2 Kidney Health for Everyone Everywhere – From prevention to detection and equitable access to care | NefrologÃa
https://revistanefrologia.com/en-kidney-health-for-everyone-everywhere-articulo-S201325142030047X
In patients with advanced CKD, management of co-morbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. […] Political efforts are needed to proliferate the preventive approach. […] Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals and policy makers. […] Measures to achieve effective primary prevention should focus on the two leading risk factors for CKD including diabetes mellitus and hypertension. […] Among measures to prevent emergence of de novo CKD are screening efforts to identify and manage persons at high risk of CKD, especially those with diabetes mellitus and hypertension. […] The cornerstone of the pharmacotherapy in secondary prevention is the use of angiotensin pathway modulators, also known as reninangiotensinaldosterone system inhibitors (RAASi).
#2 The Benefits of Plant-Based Nutrition: Treatment and Prevention of Chronic Kidney Diseaseâ¯ – American College of Lifestyle Medicine
https://lifestylemedicine.org/articles/benefits-plant-based-nutrition-chronic-kidney-disease/
Whole food, plant-based diets offer two advantages for prevention and treatment of CKD. First, higher consumption of plant foods are protective against the disease; second, lower consumption of animal and higher protein foods reduce renal burden. […] Plant-based diets are the key to controlling acid load to keep metabolic acidosis in check and thus slow progression of kidney disease. […] Whole food, plant-based diets have the dual advantages of supplying nutrients and antioxidants that support and potentially heal damaged kidneys and eliminate the processed and animal foods associated with greater risk for CKD. […] Studies indicate that the benefits of plant-based diets can be applied to all populations to address kidney dysfunction, even in the elderly at advanced stages. Plant-based diets have been demonstrated to be safe and useful in preventing and treating all chronic diseases, including type 2 diabetes, obesity, hypertension, and hyperlipidemia, which are common comorbidities of CKD. The utility of plant-based diets for CKD has become increasingly apparent. […] Overall, existing evidence indicates that diets rich in fruits and vegetables can reduce the dietary acid load and offer an exciting approach to treating CKD by reducing kidney damage, slowing disease progression, and, most importantly, helping patients improve their quality of life.
#2
https://link.springer.com/article/10.1007/s00467-020-04604-5
The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. […] Crucially, however, the onset and progression of CKD are often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventionsbe it primary, secondary, or tertiary. […] Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. […] In patients with advanced CKD, the management of comorbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation.
#2 Preventive Health Care in CKD and End-stage Renal Disease
https://www.medscape.org/viewarticle/570239_3
Daily aspirin therapy could help to prevent staphylococcal infection in patients with CKD or ESRD. […] Evaluation of oral health can be important for health maintenance in patients with CKD or ESRD and should be actively encouraged. […] Antibiotic prophylaxis before invasive dental or periodontal procedures should be considered for patients with CKD or ESRD who have prosthetic valves or congenital cardiac defects and those with a history of endocarditis or cardiac transplantation. […] Patients with hemodialysis catheters are at high risk of developing endocarditis; administration of single-dose oral amoxicillin (2 g) or single dose oral clindamycin (600 mg) before dental procedures should be considered for those who are allergic to penicillin. […] In light of the increased risk of pulmonary infection that is associated with CKD and ESRD, influenza and pneumococcal vaccinations can be preventive and should be administered to preclude morbid complications.
#2 11 Tips to Prevent Kidney Failure, Treatment Options & More
https://www.healthline.com/health/kidney-health/how-to-prevent-kidney-failure
Reducing stress and anxiety can lower your blood pressure, which is good for your kidneys. […] Because high blood pressure and diabetes are the most common causes of kidney failure, many of the prevention tips are related to managing these two conditions. […] Diabetes increases your risk for heart disease and kidney failure. Thats just one reason to manage your blood sugar. […] High blood pressure can increase your risk for heart disease as well as kidney failure. […] Obesity can increase your risk for conditions associated with kidney failure, such as diabetes and high blood pressure. […] A heart-healthy diet one low in sugar and cholesterol and high in fiber, whole grains, and fruits and vegetables helps prevent weight gain. […] Eating too much salt is associated with high blood pressure.
#2 Chronic Kidney Disease (CKD) prevention | Africa Health Organisation
https://aho.org/news/chronic-kidney-disease-prevention/
Routine use of calcium and vit D is recommended in all CKD patients not only for maintaining good bone health but also to delay progression of the disease. […] A great number of individuals with CKD may be unaware of their disease and thus may be at risk for further kidney injury through use of NSAIDs. […] Correction of acidosis with sodium bicarbonate is associated with significantly slower progression of CKD. […] Improving Global Outcomes (KDIGO) workgroup recommend that all adults with newly diagnosed CKD should undergo lipid profile testing. […] Plant-based diets delays progression to ESRD and dialysis and potentially improves survival. […] The Modification of Diet in Renal Disease (MDRD) Study suggested that a low-protein diet slows down the GFR decline and reduces proteinuria. […] Reduction in salt intake slows the progression of diabetic CKD by lowering blood pressure. […] Smoking should be strictly avoided as this decreases the risk for future onset of kidney failure.
#2 End-Stage Renal Disease: Care Instructions | Kaiser Permanente
https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.end-stage-renal-disease-care-instructions.tw12424
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. […] Do not take anti-inflammatory medicines such as ibuprofen and naproxen. They can make chronic kidney disease worse. […] Follow a diet plan that is easy on your kidneys. A dietitian can help you create an eating plan with the right amounts of salt (sodium), potassium, and protein. You may also need to limit how much fluid you drink each day. […] Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.
#2
https://journals.lww.com/jfmpc/fulltext/2020/09080/chronic_kidney_diseases__a_realm_for_preventive.4.aspx
Prevention through vaccination remains the best strategy to minimize the adverse consequences associated with these infectious diseases in this and all populations. […] The World Kidney day 2020 theme Kidney Health for Everyone Everywhere-From Prevention to Detection and Equitable Access to Care stresses upon the importance of preventive interventions-be it primary, secondary or tertiary.
#2 Chronic kidney disease: Symptoms, stage, treatment, and more
https://www.medicalnewstoday.com/articles/172179
People who are at high risk of developing CKD should have regular kidney function checks. Early detection can help prevent severe kidney damage. […] It is essential that people receive an early diagnosis of and prompt treatment for kidney disease to prevent serious damage. […] Some conditions, such as diabetes, increase the risk of CKD. Controlling diabetes can reduce the risk of developing kidney failure. Individuals should follow their doctors instructions, advice, and recommendations. […] Eating a healthy diet can help a person lower their blood pressure. […] Getting regular physical activity is ideal for maintaining healthy blood pressure levels. It also helps control chronic conditions, such as diabetes and heart disease. […] Excessive alcohol and drug use, as well as long-term exposure to heavy metals such as lead, fuels, solvents, and other toxic chemicals can contribute to kidney disease.
#2 Kidney Health for Everyone Everywhere: From Prevention to Detection and Equitable Access to Care | Li | World Journal of Nephrology and Urology
https://wjnu.org/index.php/wjnu/article/view/402/336
Given the pressing urgency pertaining to the need for increasing education and awareness on the importance of the preventive measures, we suggest the following goals to redirect the focus on plans and actions: 1) Empowerment through health literacy in order to develop and support national campaigns that bring public awareness to prevention of kidney disease; 2) Population-based approaches to manage key known risks for kidney disease, such as blood pressure control and effective management of obesity and diabetes; 3) Implementation of the World Health Organization (WHO) Best Buys approach including screening of at-risk populations for CKD, universal access to essential diagnostics of early CKD, availability of affordable basic technologies and essential medicines and task shifting from doctors to front-line healthcare workers to more effectively target progression of CKD and other secondary preventative approaches.
#2
https://link.springer.com/article/10.1007/s00467-020-04604-5
The role of primary healthcare professionals in the implementation of CKD prevention strategies in LMIC countries has been recently illustrated. […] It is important to enhance the promotion and implementation of Prevention of kidney disease and kidney failure amongst healthcare professionals, it is equally important to promote Prevention with education programs for those at risk of kidney disease and kidney failure, and with the general population at large. […] Given the pressing urgency pertaining to the need for increasing education and awareness on the importance of the preventive measures, we suggest the following goals to redirect the focus on plans and actions: Empowerment through health literacy in order to develop and support national campaigns that bring public awareness to prevention of kidney disease.
#2
https://link.springer.com/article/10.1007/s00467-020-04604-5
Population-based approaches to manage key known risks for kidney disease, such as blood pressure control and effective management of obesity and diabetes. […] Implementation of the World Health Organization (WHO) Best Buys approach including screening of at-risk populations for CKD, universal access to essential diagnostics of early CKD, availability of affordable basic technologies and essential medicines, and task shifting from doctors to frontline healthcare workers to more effectively target progression of CKD and other secondary preventative approaches.
#2 Kidney Health for Everyone Everywhere – From prevention to detection and equitable access to care | NefrologÃa
https://revistanefrologia.com/en-kidney-health-for-everyone-everywhere-articulo-S201325142030047X
In patients with advanced CKD, management of uremia and related comorbid conditions such as anemia, mineral and bone disorders, and cardiovascular disease is of high priority, so that these patients can continue to achieve highest longevity. […] Given the close links between CKD and other NCDs, it is critical that CKD advocacy efforts be aligned with existing initiatives concerning diabetes, hypertension, and cardiovascular disease, particularly in LMIC. […] The integration of CKD prevention into NCDs program, has resulted in the reduction of renal and cardiovascular risks in the general population. […] To reduce the risk of kidney failure, the program contemplates advancing public health surveillance and research to identify populations at risk and those in early stages of kidney disease, and to encourage adoption of evidence-based interventions to delay or stop progression to kidney failure.
#2 Kidney disease prevention
https://www.kidneyfund.org/all-about-kidneys/kidney-disease-prevention
Quitting can help lower your chance of getting kidney disease or help prevent your kidney disease from getting worse. […] The only way to know how well your kidneys are working is to get tested. Testing is especially important if you have diabetes, high blood pressure or a family history of kidney disease. […] Be proactive in knowing about your kidneys and ways to protect them. No one should be more invested in protecting them than you!
#2 Chronic kidney disease and the global public health agenda: an international consensus | Nature Reviews Nephrology
https://www.nature.com/articles/s41581-024-00820-6
Given its increasing prevalence, if CKD remains largely undetected and is consequently not treated, the numbers of people developing kidney failure and requiring expensive kidney replacement therapy (KRT) will naturally increase. […] Early disease detection and a life course approach are cornerstones for reducing CKD-related morbidity and mortality worldwide. […] CKD meets the WHO principles for screening as the disease is asymptomatic in its early stages and effective early interventions are available. […] One of the main historical arguments against CKD screening has been the lack of effective therapies to slow disease progression, but this landscape has changed dramatically in the past 5 years. […] Prioritizing kidney disease will also facilitate the development and expansion of kidney disease registries. […] Recognizing kidney disease as a major driver of NCD-related mortality will translate into coordinated global efforts to minimize the burden of kidney disease and will save lives.