Здоровые почки всем и везде: от профилактики и выявления до равного доступа к медицинской помощи
P.K. Li, G. Garcia-Garcia, S.-F. Lui, S. Andreoli, W.W. Fung, A. Hradsky, L. Kumaraswami, V. Liakopoulos, Z. Rakhimova, G. Saadi, L. Strani, I. Ulasi, K. Kalantar-Zadeh
1) Department of Medicine and Therapeutics, Carol & Richard Yu PD Research Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong;
2) Nephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, University of Guadalajara Health Sciences Center, Guadalajara, Jal., Mexico;
3) Division of Health System, Policy and Management, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong;
4) James Whitcomb Riley Hospital for Children, Indiana University School Of Medicine, Indianapolis, USA;
5) World Kidney Day Office, Avenue des Arts, Brussels, Belgium;
6) Tanker Foundation, Chennai, India;
7) Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece;
8) Nephrology Unit, Department of Internal Medicine, Faculty of Medicine, Cairo University, Giza, Egypt;
9) Renal Unit, Department of Medicine, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria;
10) Division of Nephrology and Hypertension and Kidney Transplantation, University of California Irvine School of Medicine, Orange, CA, USA
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. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual healthcare budget in high-income countries. 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. This complementing article focuses on outlining and analyzing measures that can be implemented in every country to promote and advance CKD prevention. 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. 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. While national policies and strategies for non-communicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management and treatment are often lacking. Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals and policy makers.
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Об авторах / Для корреспонденции
Philip Kam-Tao Li – MD FRCP FACP, Department of Medicine and Therapeutics Prince of Wales Hospital, Chinese University of Hong Kong, 30–32 Ngan Shing Street, Shatin, New Territories; Hong Kong, China. E-mail: firstname.lastname@example.org