World Kidney Day_LEAD
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If your doctor has told you that you have chronic kidney disease (CKD), it can come as a shock. Although many medical advances have been made in the treatment of kidney and urinary tract disease, the emotional effects of kidney failure on patients and their families remain great because it involves changes on several levels.

Living with chronic kidney disease can often be challenging and distressing, especially if the disease is progressing and you’re faced with the possibility of dialysis. Even in situations like this, there are ways to get in front of the disease and protect your kidneys from further harm. This not only involves making healthier lifestyle choices — including maintaining a special diet, exercising, and quitting cigarettes, if you smoke — but building a support team that is able to help you negotiate the daily rigours of living with CKD.

Dr Venkat Sainaresh Vellanki, Director, Transplant Nephrology, Burjeel Medical City, Abu Dhabi

World Kidney Day (WKD) is observed every year in the second week of March to raise awareness about kidney health. It is a joint initiative of the International Society of Nephrology and the International Federation of Kidney Foundations. A theme is chosen every year on the occasion of WKD focusing on the importance of the kidneys, and reducing the frequency and impact of kidney diseases and their associated health problems worldwide. This year’s theme is “kidney health for all, preparing for the unexpected and supporting the vulnerable” and that is reflected through initiatives undertaken by healthcare institutions around the world.

The recent Covid-19 pandemic has tested the resilience of healthcare providers to the max and presented invaluable insight into caring for this vulnerable segment — kidney patients — through major disasters, be they manmade or environmental, local or global. “It is important to be prepared when disaster strikes, as kidney patients are dependent lifelong on reliable and timely delivery of treatments to sustain life,” says Dr Venkat Sainaresh Vellanki, Director, Transplant Nephrology, Burjeel Medical City, Abu Dhabi.

Dr Azeem Ahamed, Specialist Nephrology, Aster Clinics, Bur Dubai (AJMC) & Aster Hospital, Mankhool

During the pandemic, the hospitals under Burjeel Holdings created an urgent capacity to test large volumes of Covid PCR samples to keep kidney patients safe. The hospitals reached out to Covid-affected patients needing kidney care/dialysis support in ICUs and long-term rehabilitation programmes. “During the peak Covid period in 2020, we started a full-fledged division of nephrology, capable of handling a wide variety of kidney patients, including the provision of modern dialysis service to Covid patients at Burjeel Medical City, Abu Dhabi, and Burjeel Royal Hospital, Al Ain,” says Dr Vellanki. “This lessened dependence on other hospitals that were converted to Covid hospitals by authorities.”

Emergency preparedness

The crisis emanating from non-communicable diseases(NCD) has been aggravated by global disasters, which also include earthquakes, floods, wars, extreme weather. NCDs such as cardiovascular disease, diabetes, hypertension, chronic lung disease and CKD, are the leading cause of deaths and disabilities worldwide.

Dr Azeem Ahamed, Specialist Nephrology, Aster Clinics, Bur Dubai (AJMC) & Aster Hospital, Mankhool, says, “Governments and policy makers around the world should give special attention and care in emergency preparedness plans in the detection of NCDs, which include kidney disease, hence the importance of this theme for the World Kidney Day 2023.”

Dr Ahamed cautions that kidney diseases are silent killers and mostly remain undiagnosed, which can significantly affect your quality of life. In fact 2.3 billion people worldwide are at risk of developing chronic kidney disease (CKD) and around 840 million people actually develop CKD. “The prevalence in the middle east is estimated to be around 12 per cent but the actual figure may be higher when correlated with the high prevalence of known CKD risk factors including hypertension and diabetes in the Middle East and the UAE,” he says.

Kidney diseases rank among the top 10 causes of years of life lost in the GCC/MENA. As per 2016 estimates, kidney disease is widely prevalent with an estimated one in 10 individuals being affected. It is estimated that by 2040, kidney disease will rank among the top five causes of mortality. Genetically, explains Dr Vellanki, Middle Eastern populations have a high prevalence of diabetes and hypertension, predisposing them to chronic kidney disease. “Sedentary lifestyle and obesity have further aggravated the kidney disease burden,” says Dr Vellanki. “A large expatriate workforce in Middle Eastern countries who work outdoors in hot and humid climates are affected with a high incidence of CKD. The pandemic has accelerated the progression of CKD in many high-risk individuals as well.”

Kidney disease caused by diabetes mellitus and hypertension is now reaching epidemic proportions. Obesity and lifestyle-related kidney disease is on the rise too. “Kidney and urinary tract infections, kidney stones, substance, and medication abuse, rheumatological disease, cardiac ailments causing kidney failure, and glomerulonephritis also form a significant part of nephrology practice universally,” says Dr Vellanki.

So then, how far away are we from finding a cure for kidney disease? Experts reiterate that it is important to detect it at an early stage through regular screening. In some instances, it may be possible to aim for a cure but by the time it is diagnosed, it is often too late. “At that time, the focus then shifts to slowing the progression of the disease rather than the cure itself,” says Dr Vellanki. “If you belong to high-risk groups or are diagnosed with kidney disease, it is important to follow up with a kidney specialist regularly. This may add many productive years to your life.”