Data from Pharmawand - Curated by EPG Health - Date added 11 June 2019

In Hungary, more than about 10,000 patients are dependent on dialysis treatment or have undergone renal transplantation. ”But what we are now seeing in terms of CKD prevalence may only be the tip of the iceberg”, says Professor George Reusz, Congress President of the 56th Congress of the European Renal Association - European Dialysis and Transplantation Association (ERA-EDTA). Taking advantage of the annual congress the association works towards sensitizing the population and policymakers to the problem of CKD and demand that preventive measures are taken quickly.

About 10 - 11% of the European population is affected by chronic kidney disease (CKD). Worldwide, over 850 million people suffer from kidney diseases. These people have lost some of their kidney function and are at high risk of becoming dependent on renal replacement therapies (dialysis or transplantation). A frequent misconception is that the CKD population is identical to those on dialysis. However, dialysis patients represent about 1 to 2% of the population with CKD. With 9.8 million inhabitants in Hungary nearly 1 million people suffer from kidney diseases of any kind, and so far about 10,000 patients are in need of renal replacement therapy (about 6,000 dialysis patients and 4,000 transplanted patients). But this number of CKD patients is growing.

The increase in CKD patients is ascribed in part to the demographic trends – people are becoming older, and loss of renal function is a symptom of old age. Yet demographic trends alone do not explain an upward trend in chronic kidney disease (CKD). Several other conditions are linked to increased incidence of CKD, e.g. diabetes mellitus, hypertension, smoking, ageing, and obesity. All subjects having these characteristics should not only be adequately treated for their primary condition, but should also be regularly screened and treated specifically for their kidney disease.

CKD is still frequently neglected as a health hazard, despite being epidemiologically and economically important. The increasing prevalence of CKD is also a growing problem for the healthcare economy. The annual costs incurred for a dialysis patient in Europe are estimated at approx. EUR 60,000 - 80,000.

One reason for the neglect of CKD might well be that the ‘alarm signals’ for CKD are few, until it has progressed to an advanced stage, when preventive measures have no further impact. An even more concerning problem is the lack of awareness among the general population and among the medical community of the risks of kidney disease. The only options for reducing the dialysis population, or at least for keeping it stable over the long term, are to improve the early detection of CKD and to promote kidney transplantation. ‘We see enormous potential in the field of early detection, especially, because it can stop the disease from advancing, or slow its progress at least’, explains Professor George Reusz, Congress President of the 56th Congress of the European Renal Association - European Dialysis and Transplantation Association (ERA-EDTA) that takes place from 13 June to 16 June, 2019, in Budapest.

However, it is not only the rising number of kidney failure, which is dramatic, but also the outcome: “Even, if many patients with impaired kidney function do not feel ill over a long period of time, they are at a particularly high risk of many other health outcomes due to this condition”, explains Professor Carmine Zoccali, president of the ERA-EDTA. As he points out, the average age standardized mortality rate due to low kidney function (GFR) is 21 deaths per 100,000 [1]. In particular, the cardiovascular death toll from chronic kidney diseases is huge: In 2013, there were 17.9 million cardiovascular deaths attributed to kidney diseases in worldwide [2]. “The death rate among people with kidney diseases is incredibly high! AIDS, for example, accounts for “only” 1.9 deaths per 100,000 [3] – but think about all the campaigning with celebrities and the resulting recognition of HIV as a priority health issue. There is only little active campaigning on behalf of people with kidney diseases, even though the number of people who die from kidney deterioration is 11 times higher.”

To raise the profile of kidney disease and to enhance CKD prevention is one of the declared aims of the ERA-EDTA, the European society for nephrologists. The association works towards increasing awareness of the population and policymakers to the problem of CKD. “It is important that CKD is perceived more strongly as a problem for individual health and for healthcare economies, and that preventive measures are taken quickly, because what we are now seeing in terms of CKD prevalence may only be the tip of the iceberg”, says Prof. Reusz. “There is an urgent need to take action!”

References:
[1] GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015 Jan 10;385(9963):117-71.
[2] GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016 Oct 8;388(10053):1459-1544.
[3] Age-Adjusted Mortality Rate for HIV Disease – https://www.kff.org/hivaids/state-indicator/age-adjusted-hivmortality-rate/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D 

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