Kidney Health For Everyone Everywhere – Living Well With Kidney Disease

Every year on the second Thursday of March we celebrate WORLD KIDNEY DAY to raise awareness about the increasing incidence of kidney-related problems in our society.

Living with chronic kidney disease (CKD) is associated with hardships for patients and their care partners. Empowering patients and their care partners, including family members and friends involved in their care, may help minimize the burden and consequences of CKD-related symptoms to enable increased life participation. There is a need to broaden the focus on living well with kidney disease and re-engagement in life, including an emphasis on the patient
being in control. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of “Living Well with Kidney Disease” in an effort to increase education about and awareness of the important goal of patient empowerment and life participation

Irrespective of the type of kidney disease or treatment stage, patients wanted to be able to live well, maintain their role and social functioning, protect some a semblance of normality, and have a sense of control over their health and well-being.

The World Kidney Day Steering Committee has declared 2021 the year of “Living Well with Kidney Disease”. This has been done in order to both increase education and awareness about effective symptom management and patient empowerment, with the ultimate goal of encouraging life participation. Whilst effective measures to prevent kidney disease and its progression are important, patients with kidney disease – including those who depend on dialysis and transplantation – and their care-partners should also feel supported, especially during pandemics and other challenging periods, by the concerted efforts of kidney care communities.

In a developing country like India, kidney diseases assume more importance because of limited resources to deal with the problems on one hand and the astronomical sums of money involved in the treatment of fully evolved kidney disease called the end-stage renal disease where the only way of sustaining life is via dialysis or transplantation each of which incurs a substantial cost as well as morbidity. Unfortunately, most kidney diseases produce minimal discomfort to the patient until late in course of the disease by that time damage incurred is often permanent and irreversible. But fortunately, most kidney diseases can be easily detected early in course of the disease process by simple tests like blood pressure measurement and urine examination which are economical and readily available.

Kidneys are probably the only vital organs that can be realistically replaced by artificial means. Maintenance dialysis is a well-recognized modality of treating patients having the end-stage renal disease. 

The exact burden of Chronic Kidney disease needing maintenance dialysis and/or renal transplantation is not known, however from the existing published data prevalence of Chronic Kidney disease ranges between 0.7% to 1.4%. Whereas the incidence of End stage renal disease was estimated to be 180 to 200 per million population.

In India, the joint family structure is slowly dwindling in numbers thus putting pressure on the caretakers. This also is one of the causes of a reduction in the number of living donations.

WHAT WE NEED TO DO 

1.Empower the patients and their care-givers to achieve the health outcomes and life goals that are meaningful and important to them. The treating physician should be able to understand this for the individual patient and assist them in achieving this outcome.

2. Consistent, accessible and meaningful communication in the development, implementation and evaluation of interventions for practice and policy settings, that enable patients to live well

3. Strategies to support patient resilience, harness social connections, build patient awareness and knowledge, facilitate access to support, and establish confidence and control in self-management.

4. Strategies to identify and manage symptoms that cause suffering including pain, sleep issues, anxiety, depression, stress, mobility, frailty, and others and ask for more education and management strategies to alleviate these symptoms so that patients and their care-partners can have a better health-related quality of life.

THE 8 GOLDEN RULES:

  • Keep fit, be active
  • Eat a healthy diet
  • Check and control your blood sugar
  • Check and control your blood pressure
  • Take the appropriate fluid intake
  • Don’t smoke
  • Don’t take over-the-counter anti-inflammatory/pain-killer pills regularly
  • Get your kidney function checked if you have any ‘high risk’ factors
    • you have diabetes
    • you have hypertension
    • you are obese
    • you have a family history of kidney disease

In the overall wellness program for patients with kidney disease, the need for prevention should be reiterated. Early detection with a prolonged course of wellness despite kidney disease, after an effective secondary prevention program, should be promoted. Prevention of CKD progression can be attempted by lifestyle and diet modifications, such as a plant-dominant low-protein diet, and by means of effective pharmacotherapy.

World Kidney Day 2021 continues to call for increased awareness of the importance of preventive measures across populations, professionals, and policymakers, applicable to both developed and developing countries.

It would be the responsibility of professional organizations like USI and IMA to create awareness about Kidney disease. USI is planning to conduct a cadaver course in the latter part of this year about Deceased donor retrieval surgery. We must train our younger generation to get involved in Renal Transplantation as multiorgan transplant surgeons are slowly taking over Renal transplantation. The urological society of India would also make programs to promote the Deceased donor program which would be done easily with the involvement of the Zonal chapters of USI.

Kidney Health For Everyone Everywhere – Living Well With Kidney Disease
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