Preventing CKD in Developed Countries

Abstract

Chronic kidney disease (CKD) is an important public health concern in developed countries because of both the number of people affected and the high cost of care when prevention strategies are not effectively implemented. Prevention should start at the governance level with the institution of multisectoral polices supporting sustainable development goals and ensuring safe and healthy environments. Primordial prevention of CKD can be achieved through implementation of measures to ensure healthy fetal (kidney) development. Public health strategies to prevent diabetes, hypertension, and obesity as risk factors for CKD are important. These approaches are cost-effective and reduce the overall noncommunicable disease burden. Strategies to prevent nontraditional CKD risk factors, including nephrotoxin exposure, kidney stones, infections, environmental exposures, and acute kidney injury (AKI), need to be tailored to local needs and epidemiology. Early diagnosis and treatment of CKD risk factors such as diabetes, obesity, and hypertension are key for primary prevention of CKD. CKD tends to occur more frequently and to progress more rapidly among indigenous, minority, and socioeconomically disadvantaged populations. Special attention is required to meet the CKD prevention needs of these populations. Effective secondary prevention of CKD relies on screening of individuals at risk to detect and treat CKD early, using established and emerging strategies. Within high-income countries, barriers to accessing effective CKD therapies must be recognized, and public health strategies must be developed to overcome these obstacles, including training and support at the primary care level to identify individuals at risk of CKD, and appropriately implement clinical practice guidelines.

The Restoration of Vitamin D Levels Slows the Progression of Renal Ischemic Injury in Rats Previously Deficient in Vitamin D

“…Worldwide, the prevalence of chronic kidney disease (CKD) has been increasing over the years ( 1 , 2 ). Among others, diabetes, hypertension and obesity are well-known aggravating factors for CKD.…”

Klotho, Aging, and the Failing Kidney

“…CKD is a progressive systemic disease that affects 10–12% of the population ( 56 ). The prevalence of CKD has increased markedly over the past decades due to an aging population worldwide and an increase in incidence of obesity and type-2 diabetes; a significant driver of CKD ( 57 ). Progressive kidney damage leads to an increased number of systemic complications, hallmarked by persistent (chronic) low-grade inflammation, including hyperphosphatemia, CVD, anemia, hypertension, mineral-bone disorders, muscle wasting, osteoporosis, increasing frailty, and anemia ( 58 ).…”

A roadmap for optimizing chronic kidney disease patient care and patient-oriented research in the Eastern European nephrology community

“…Several recent landmark publications elegantly describe the overall burden and management of CKD worldwide [ 1 , 7 , 10 , 11 ], pointing to significant disparities between countries [ 12 , 13 ]. Various aspects of CKD differ significantly and are worse in the Eastern European nephrology community than Western Europe because of different geographic, socio-economic, infrastructure, cultural and educational features ( Table 1 ) [ 2 , 12 , 14–22 ].…”

“…Approximately 25–40% of adults with type 2 diabetes and 30% with hypertension develop CKD. These diseases are the primary cause of CKD, yet the majority of patients with these diseases are not aware of this association [ 13 ]. Importantly, both type 2 diabetes and hypertension are treatable, and even preventable if predisposing factors (e.g.…”

“…Introducing measures to reduce the cost of healthy food, tax unhealthy products, restrict unhealthy food advertising and regulate specific food composition (salt, fats, trans-fats and sugar) is mandatory. Notifying the consumer of the health risks of the contents through food labelling has been suggested to be an optimal approach [ 13 ].…”