MIND THE GAP IN KIDNEY CARE: TRANSLATING WHAT WE KNOW INTO WHAT WE DO.

Valerie A. Luyckx1^,2^,3^,18, Katherine R. Tuttle4^,5^,18, Dina Abdellatif6, Ricardo Correa-Rotter7, Winston W.S. Fung8, Agnès Haris9, Li-Li Hsiao2, Makram Khalife10^,19, Latha A. Kumaraswami11, Fiona Loud10^,19, Vasundhara Raghavan10^,19, Stefanos Roumeliotis12, Marianella Sierra10^,19, Ifeoma Ulasi13, Bill Wang10^,19, Siu-Fai Lui14, Vassilios Liakopoulos15, Alessandro Balducci16, for the World Kidney Day Joint Steering Committee17.

1Department of Public and Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland

2Renal Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA

3Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa

4Providence Medical Research Center, Providence Inland Northwest Health, Spokane, Washington, USA

5Nephrology Division, Department of Medicine, University of Washington, Seattle, Washington, USA

6Department of Nephrology, Cairo University Hospital, Cairo, Egypt

7Department of Nephrology and Mineral Metabolism, National Medical Science and Nutrition Institute Salvador Zubiran, Mexico City, Mexico

8Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China

9Nephrology Department, Péterfy Hospital, Budapest, Hungary

10ISN Patient Liaison Advisory Group

11Tamilnad Kidney Research (TANKER) Foundation, Chennai, India

122nd Department of Nephrology, AHEPA University Hospital Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

13Department of Medicine, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria

14Division of Health System, Policy and Management, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong

152nd Department of Nephrology, AHEPA University Hospital Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

16Italian Kidney Foundation, Rome, Italy

¹⁷The World Kidney Day Joint Steering Committee is listed in the Appendix.

¹⁸VAL and KRT are joint first authors.

¹⁹MK, FL, VR, MS, and BW are patient representatives of the Patient Liaison Advisory Group of the International Society of Nephrology.

ABSTRACT

Historically, it takes an average of 17 years to move new treatments from clinical evidence to daily practice. Given the highly effective treatments now available to prevent or delay kidney disease onset and progression, this is far too long. The time is now to narrow the gap between what we know and what we do. Clear guidelines exist for the prevention and management of common risk factors for kidney disease, such as hypertension and diabetes, but only a fraction of people with these conditions worldwide are diagnosed, and even fewer are treated to target. Similarly, the vast majority of people living with kidney disease are unaware of their condition, because in the early stages it is often silent. Even among patients who have been diagnosed, many do not receive appropriate treatment for kidney disease. Considering the serious consequences of kidney disease progression, kidney failure, or death, it is imperative that treatments are initiated early and appropriately. Opportunities to diagnose and treat kidney disease early must be maximized beginning at the primary care level. Many systematic barriers exist, ranging from patient to clinician to health systems to societal factors. To preserve and improve kidney health for everyone everywhere, each of these barriers must be acknowledged so that sustainable solutions are developed and implemented without further delay.

Keywords: Chronic kidney disease, Equity, Kidney care, Public health, World Kidney Day.

Correspondence: Winston Fung, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Ninth Floor, Lui Che Woo Clinical Science Bldg, 32 Ngan Shing St, Shatin, Hong Kong. E-mail: fws898@ha.org.hk

Valerie A. Luyckx, Department of Public and Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, Zurich 8001, Switzerland. E-mail: valerie.luyckx@uzh.ch

Brunei Int Med J.2024;20:29-43