World Kidney Day - ‘Kidney Health for Everyone Everywhere’

World Kidney Day is an annual global awareness campaign aimed at generating awareness about the importance of kidney health in order to reduce the impact and frequency of kidney disease and its associated health complications. It is a joint initiative of the International Society of Nephrology (ISN) and International Federation of Kidney Foundations (IFKF). World Kidney Day brings together kidney advocacy groups, medical professionals, researchers, students, educationists, policymakers, and the general public to organize workshops, conferences, public lectures, and outreach programs to bring attention to the importance of kidney health for maintaining overall health and wellbeing. It is held on the 2^nd Thursday of March every year. This year, it will be held on Thursday 14^th March 2019.

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World Kidney Day 2019 Theme - ‘Kidney Health for Everyone Everywhere’

Every year the campaign focuses on a particular theme. This year’s theme is ‘Kidney Health for Everyone Everywhere’, which will focus on the burden of kidney disease and disparities and inequalities in access to healthcare. The campaign calls for Universal Health Coverage (UHC) for prevention and early treatment of kidney disease.

World Kidney Day started in 2006 with just 66 countries participating in the event. Since then, it has been growing steadily and is now a global phenomenon. This year, it is expected that over 1000 events will be organized worldwide, with participation by more than 90 countries.

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Why are Kidneys So Important?

The kidneys are very important organs of the body. These are bean-shaped organs, the size of a fist, located on either side of the abdomen. Kidneys are essential for maintaining optimal health because they perform the following critical functions:

• Filter out waste products, drugs, and toxins through urine
• Regulate fluid balance in the body
• Regulate electrolyte (salt) concentrations
• Regulate blood pressure
• Maintain acid-base balance
• Control production of red blood cells
• Keep bones healthy and strong

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Kidney Disease: Facts & Figures

• Around 850 million people worldwide suffer from kidney disease
• An estimated 5-10 million people worldwide die annually from kidney disease
• Kidney disease is the 6^th fastest growing cause of death
• 1 in 10 people worldwide are affected by kidney disease
• Prevalence of chronic kidney disease (CKD) is 14 percent in women and 12 percent in men
• CKD is a silent killer as initially there are no signs or symptoms
• Acute kidney injury (AKI) is a major driver of CKD, which affects over 13 million people worldwide and kills 1.7 million people annually
• The biggest risk factors for kidney disease are uncontrolled diabetes and hypertension (high blood pressure)
• Other risk factors include cardiovascular disease, heredity and ethnicity
• Kidney failure is the last stage of kidney disease and is fatal without dialysis or a kidney transplant
• Black, Asian or minority ethnic groups are more likely to progress faster towards kidney failure
• Socially disadvantaged people are more likely to develop kidney disease, require dialysis and die from the disease

Keeping the Kidneys Healthy: The Eight Golden Rules

Some simple tips for keeping the kidneys healthy and reducing the risk of kidney disease are given below:

• Blood Pressure Monitoring: Since high blood pressure can accelerate kidney damage, regular monitoring of blood pressure is required for early detection of hypertension
• Blood Sugar Monitoring: Since diabetes is a major risk factor for kidney disease, blood glucose should be regularly monitored to prevent uncontrolled diabetes
• Active Lifestyle: Keeping fit and leading an active lifestyle can help to reduce blood pressure and thereby reduce the risk of kidney disease
• No Smoking: Since smoking reduces the blood flow to the kidneys and hamper their proper functioning, smoking should be completely avoided. Moreover, smoking increases the risk of kidney cancer by 50 percent
• Diet Control: A balanced, healthy diet is recommended for kidney disease patients which will keep the body weight in check. This will help to prevent diabetes, cardiovascular disease and other conditions associated with kidney disease
• Kidney Function Test (KFT): This test assesses whether the kidneys are functioning properly. Performing KFT at regular intervals is recommended in case of diabetes, hypertension, obesity or if there is a family history of kidney disease
• Proper Hydration: Keeping the body well hydrated helps the kidneys to flush out toxins, thereby significantly lowering the risk of kidney disease and reducing chances of urinary tract infections (UTI) and formation of kidney stones. However, dialysis patients need to limit their fluid intake
• Limiting OTC Drug Use: Over-the-counter (OTC) medicines such as non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen, indomethacin, naproxen and others, should not be taken regularly as these can cause kidney damage

Challenges to Kidney Health

The major challenges are highlighted below:

• Disparity & Inequality: There are huge disparity and inequality in kidney health, despite the ever-increasing burden of kidney disease. These can arise due to lack of education, gender discrimination, and occupational hazards, among others
• Social Deprivation: This can arise due to abject poverty, often resulting in being deprived of basic healthcare facilities
• Transplantation Barriers: There may be multiple barriers for implementation of transplantation, including high set-up costs, the requirement for highly specialized medical teams, need for dialysis backup, and the availability of organ donors
• Lack of Policies: There is a lack of specific policies with regard to screening, prevention and treatment of kidney diseases. This negatively impacts the management of patients with CKD

The Way Forward

The following strategies could be adopted to overcome the challenges:

• Awareness & Advocacy: Creation of awareness and more advocacy in all aspects of kidney health is a major aim of the campaign and should be promoted. This includes identification of risk factors, prevention strategies and ways to cope with kidney disease
• Screening: The two major risk factors for CKD are diabetes and hypertension. Screening should be encouraged to identify diabetic and hypertensive patients for early detection of this high-risk population
• Education: Patient education has an immense impact in preventing kidney disease and in this regard, the role played by doctors is vital. Hence, medical professionals should be made aware of their pivotal role, not only in diagnosis and treatment, but also in patient education and counseling
• Kidney Donation & Transplantation: The crucial role of kidney transplantation as a life-saving procedure for kidney failure patients should be highlighted and adequate infrastructure should be developed. Moreover, the act of kidney donation should be encouraged as a noble gesture to help those with kidney failure
• Political Will: Greater political commitment at the local, national and international levels by way of financial support is crucial for successful implementation of kidney disease prevention strategies. Therefore, the need for more political will should be emphasized

Conclusion

From the foregoing discussion, it is quite evident that many hurdles still exist that hamper progress in achieving ‘Kidney Health for Everyone Everywhere’. Despite this, huge strides have already been made, thanks to campaigns like the World Kidney Day. This provides an ideal platform to discuss, debate and find solutions to the problems so that kidney patients can look forward to a better quality of life in the future.

References:

1. World Kidney Day - National Health Portal, Ministry of Health & Family Welfare, Government of India - (https://www.nhp.gov.in/world-kidney-day_pg)
2. World Kidney Day 2019 - Kidney Care UK - (https://www.kidneycareuk.org/news-and-campaigns/world-kidney-day-2019/)
3. How Your Kidneys Work - National Kidney Foundation - (https://www.kidney.org/kidneydisease/howkidneyswrk)
4. World Kidney Day: ‘Kidney Health for Everyone Everywhere’ - (https://www.worldkidneyday.org/)
5. The Global Burden of Kidney Disease and the Sustainable Development Goals - World Health Organization - (https://www.who.int/bulletin/volumes/96/6/17-206441/en/)
6. World Kidney Day - International Society of Nephrology (ISN) - (https://www.theisn.org/advocacy/world-kidney-day)

Source-Medindia