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WORLD KIDNEY DAY (1)WORLD KIDNEY DAY (1)PURPOSE:PURPOSE:
1.1.World Kidney Day was established to World Kidney Day was established to increase awareness of the need for detection increase awareness of the need for detection programs for CKD & to improve programs for CKD & to improve prevention & treatment of CKD. prevention & treatment of CKD. 2.The motto of World Kidney Day: 2.The motto of World Kidney Day:
Kidney Disease is Common, Kidney Disease is Common, Harmful and Treatable.Harmful and Treatable.
About 20 Million People With Chronic Kidney Disease (CKD) in
the United States and ~20 Million More at Risk
Estimates Suggest That About 10 Percent of Adult Patients Worldwide
May Have CKD
Most People with CKD will Die Prematurely from their Increased
Risk of Cardiovascular and Cerebrovascular Disease Before they Develop End-Stage Kidney
Failure
Dialysis Mortality: 20% General Population vs ESRD Dialysis Patients
RN Foley, PS Parfrey, and MJ Sarnak; Clinical epidemiology of cardiovascular disease in chronic renal disease AJKD, 1998 32(5):S112-S119
0.001
0.01
0.1
1
10
100
25-34 35-44 45-54 55-64 66-74 75-84 >85
GP Male
GP Female
GP Black
GP White
Dialysis Male
Dialysis Female
Dialysis Black
Dialysis White
Age (years)
An
nu
al C
VD
Mo
rtal
ity
(%)
Diabetes50%
Hypertension27%
Glomerulonephritis13%
Other10%
Primary Diagnoses for Patients Who Start Dialysis
United States Renal Data System (USRDS) 2005 Annual Data Report • WWW.USRDS.ORG
WHY WORLD KIDNEY DAY?
• Chronic, non-communicable diseases (i.e. CVD, HTN, DM and CKD) have now replaced communicable diseases as the LEADING THREAT to public health & health budgets worldwide
• Deaths…– Attributed to infectious diseases will decline
by 3% over the next decade– Attributed to chronic diseases will increase by
17% over the same time frame
Interconnections Between Obesity, Diabetes
Mellitus, High Blood Pressure, and Chronic Kidney Disease (CKD)
Interconnections Between Obesity, Diabetes Mellitus (DM), High Blood
Pressure, and Chronic Kidney Disease (CKD)
Relationships between Obesity, Diabetes & CKD: i. Obesity predisposes to both Diabetes & CKD ii. Diabetes is the most common cause of end-stage CKD that requires chronic dialysis treatments or renal transplantation iii. Roughly one-third of people with Diabetes will develop CKD
Interconnections Between Obesity, Diabetes Mellitus, High Blood Pressure,
and Chronic Kidney Disease (CKD)
Relationships between Obesity, Diabetes & CKD:(continued)
iv. Diabetes is easy to detect, can be prevented in most cases, and can usually be treated effectively in most cases.
Interconnections Between Obesity, Diabetes Mellitus, High Blood Pressure, and Chronic
Kidney Disease (CKD)
Relationships between CKD & high blood pressure: i. High blood pressure, like chronic kidney disease (CKD), is often silent and dangerous. ii. High blood pressure causes CKD. iii. CKD causes High blood pressure. iv. Both CKD and Hogh blood pressure are common and treatable.
Interconnections Between Obesity, Diabetes Mellitus, High Blood Pressure,
and Chronic Kidney Disease (CKD)
Relationships between Obesity, Diabetes, CKD, High blood pressure versus Vascular Disease: 1. Each of the above four conditions increase the risk for Cardiovascular and Cerebrovascular Disease. 2. This risk is often markedly increased. 3. Together these 4 diseases (Obesity, Diabetes, CKD and high blood pressure) cause a large percentage of the illnesses and deaths in the Developed and the Developing World.
Interconnections Between Obesity, Diabetes Mellitus, High Blood Pressure,
and Chronic Kidney Disease (CKD)
What can We do to Prevent and Treat these Related Diseases and Their
Harmful Effects?
Challenges of CKD Management problems, enormous Management problems, enormous everywhere, are particularly great, even everywhere, are particularly great, even overwhelming, in developing countries:overwhelming, in developing countries:1. Little awareness of CKD or its 1. Little awareness of CKD or its consequences consequences 2. Few financial resources for 2. Few financial resources for prevention, detection or treatment prevention, detection or treatment 3. Little expertise3. Little expertise4. High prevalence of CKD4. High prevalence of CKD
What Can Be Done (1)?
1.Advertise/Educate i. The public-at –large ii. National, regional and local
governments, insurers and other health related organizations (eg, the pharmaceutical industry)
iii. Health care professionals (There is abundant evidence that medical care is suboptimal nationally, even when financial resources are not a limiting factor).
WORLD KIDNEY DAY (2)WORLD KIDNEY DAY (2)
A SUCCESS STORY:A SUCCESS STORY:
There has been an overwhelming There has been an overwhelming response around the world to response around the world to World Kidney Day.World Kidney Day.
WKD Successes (1)• Outstanding response from around the
world:
– 45 participating countries - 2006
– 63 participating countries - 2007
– 90 participating countries & territories – 2008
– Over 100 participating countries & territories -2009 (estimated)
WKD Successes (2)Participating Countries
– from Albania to Zimbabwe– In many countries, activities in many different
places– Participating organizations included:
societies, foundations, universities, colleges, hospitals associations, trusts and individuals
– Local activities focused on raising awareness across all key audiences:
– Public-at -large, Government ministers and Health Officials, Physicians and Allied Health Professionals
What Can Be Done (2)?
2. Conduct Detection and Treatment Programs i. Particularly for high risk groups. ii. Employ inexpensive methods of detection and
treatment (Experience of Dr. Manis from Chennai, consider using non-physicians where possible).
iii. Collaboration with other like-minded organizations will increase efficiency and effectiveness – especially for a nation as populous and with as many volunteer health organizations as India.
Today There are Many Safe and Effective Treatments That Prevent or Slow the Progression of Chronic Kidney Disease
Simple Methods for Detection of CKD
1. Urine Albumin, including Microalbumin (indicator of kidney disease especially of small blood vessels in kidney)
2. Serum Creatinine (indicator of kidney function)
3. Blood Pressure
What Can Be Done (3)?
3. New Direction:
We are beginning to join with other disease focused groups and world health days that relate to kidney disease (for example, World Hypertension Day, possibly in the future, World Diabetes Day).
What Can Be Done (4)?
4. Ultimately, the costs of prevention, detection and treatment programs nationally will require resources that can only be provided by such national or regional organizations as governments or other third party insurers – But this is for the future.
Potential Evolution in Goals for Potential Evolution in Goals for World Kidney Day World Kidney Day
The goal is to use World Kidney Day as a The goal is to use World Kidney Day as a mechanism to stimulate people to work together mechanism to stimulate people to work together to improve the health care system as it affects to improve the health care system as it affects public health, preventative medicine and acute public health, preventative medicine and acute and chronic medical care in their locality with and chronic medical care in their locality with regard to acute and chronic kidney disease .regard to acute and chronic kidney disease .
We want to have volunteers from kidney We want to have volunteers from kidney foundations, kidney patient organizations, foundations, kidney patient organizations, societies of nephrology, other interested societies of nephrology, other interested organizations and the public-at-large join organizations and the public-at-large join together to attain these goals in their locality.together to attain these goals in their locality.
World Kidney Day Los Angeles World Kidney Day Los Angeles 2009 (1)2009 (1)
Many Southern California Organizations joined together for this event
March 12, 2009
1.Minority community education program and focus groups – Drew Postgraduate Medical School, Community Organizations
2.KEEP it Hollywood - NKFSC
3.Dinner Lecture – NKFSC, Teaching Programs
World Kidney Day Los Angeles World Kidney Day Los Angeles 2009 (2)2009 (2)
Many Southern California Organizations joined together for this event (continued)
March, 2009
4. Kidney Disease Lectures at Scheduled Hospital Conferences, Universities - Academic Nephrologists
World Kidney Day Los Angeles World Kidney Day Los Angeles 2009 (3)2009 (3)
Many Southern California Organizations joined together for this event (continued)
March 14, 2009
5. CKD Management Training for MD’s, RN’s, General Internists, Family Practitioners, Nurse Practitioners and Specialists, Case Managers – Kaiser Permanente Health Care System and Foundation, Los Angeles County Department of Health Services
World Kidney Day Los Angeles World Kidney Day Los Angeles 2009 (4)2009 (4)
Many Southern California Organizations joined together for this event (continued)
March, 2008 – March, 2009
6. Innumerable planning meetings and individual activities – By representatives of all of the above organizations and entities
7. In Washington and elsewhere, meeting with government officials, editorials, the media and many many other activities