World Kidney Day (WKD) is an awareness campaign, held throughout the globe on 2nd Thursday of March every year. What began as small initiative in 2006 has expanded into a world-wide campaign that involves renal societies, NGO’s, celebrities, governments to aware the common man about various aspects of kidney health both related to its disease and ways to mitigate such illnesses.
Every year there is a theme put forth by experts with an aim to reduce the frequency of kidney diseases in high risk population and also help to retard the progression in patients who already have early kidney disease by timely and appropriate intervention. This year on 9th march we are celebrating the 18th wkd with the theme – “living well with kidney disease – preparing for the unexpected, supporting the vulnerable”.
Non-communicable diseases (NCDs), including diabetes, hypertension, chronic lung disease, chronic kidney disease (CKD), cardio-vascular diseases and cancer are known to be the leading causes of death and disabilities worldwide, especially in low- and middle-income countries. Most of these diseases are a nightmare both for a person suffering as well as to the family. Any NCD in its initial stage may not require the help from any but as the disease advances and affects multiple organ systems the person becomes dependent on his family/government for all modalities of management be it the medications, tests, doctor visits, hospitalization and interventions.
In order that a CKD patient doesn’t reach a stage where his dependence on the system or family becomes mandatory, the nephrologists try their best to protect the kidneys, treat the underlying diseases (especially diabetes, and hypertension) as quick and as adequately as possible, so that patient does not land into advanced form of kidney failure. If the kidney ailment is not all correctable, the primary aim is the delay the progression of the disease as much as possible with drugs, diet restrictions and other measures so that patient does not reach a stage (end-stage) where the need for dialysis and transplant is a must, which have a huge social and economic bearing.
Many things can impair the health care delivery even in the best of the countries. Besides the inherent deficiency of a particular health care system, we recently witnessed some events that has exposed our deficiencies and changed our planning as far as health set up is concerned. Disastrous events either local (floods, earthquake, war) or global (COVID-19) do have a significant impact on the functioning and living conditions of the community as a whole with varied consequences which may be human, material, economic and environmental losses.
The Covid-19 pandemic kept us on toes in 2020 and 2021, while the recent earthquake in Turkiye & Syria and the war in Ukraine have jolted all of us in general and the local sufferers in particular. These events besides affecting the healthy individuals have more effect on those affected by chronic diseases, of which kidney patients represent a sizeable number worldwide. Patients are particularly affected by these disruptions, as the ability to access proper diagnostic services, treatments and care is greatly jeopardized.
In the event of emergencies, all patients with NCDs, especially CKD patients are among the most vulnerable due to their ongoing requirements for consistently coordinated care – which is often life long, and involving complex ongoing treatment. Within this patient group there are people who are further marginalized especially the women folk, people of poor socio economic status, people living in difficult terrains, elderly people who have limited family support. These vulnerable and marginalized groups especially in times of disasters are the mainstay of attention on this WKD-2023. How to address their issues related to their kidney health is the theme of this year’s WKD.
The COVID-19 pandemic and the natural (earthquake) or man-made (war) disasters has delineated the challenges faced by health care systems in providing essential health services to patients with NCDs. COVID-19 put up an added strain on this vulnerable population, who have had to deal with the risk of becoming infected while visiting health facilities, or the suspension or cancellation of non-COVID-19 care due to health service capacity limits and lockdown policies. With no actual cure or treatment to prevent progression of CKD, the unhindered progression of CKD to kidney failure will most certainly increase the global need for life-saving costly treatments of dialysis and transplantation, a limitation in under-developed countries.
Finally, these recent disasters have aggravated an already insufficient global political health commitment on NCDs. With insufficient public health funds that focus on management rather than prevention of only a few of these NCDs – cardiovascular disease, cancer, diabetes, and chronic respiratory disease, it is estimated that 55% of the global NCD burden is attributed to diseases outside of this group, such as kidney disease. We also have to remember that the burden of NCDs is amplified in the presence of kidney disease, frequently co-existing. We need urgent public health policy that better reflects the opportunities in preventive strategies and the importance of both the magnitude and synergistic aspects of kidney disease as part of the NCD burden.
The COVID-19 pandemic and the earthquake taught us that preparation for unexpected events is incredibly important for kidney patients. We need to
Adopt integrated health strategies that prioritize prevention, early detection, and management of NCDs, including kidney disease.
Provide equitable and proper access to care for chronic patients in times of emergency.
Include emergency preparedness plans in the management and detection of NCDs.
Educate patients to plan for emergencies by having an emergency kit (food, water, medical supplies, and medical records).
With awareness through various campaigns done on the WKD in Kashmir, we can help people to live long without any kidney problems , and also urge authorities to make advanced plans to manage such patients in case of disasters and eventualities.
Dr Muzafar Maqsood Wani, Consultant Nephrologist, SKIMS, Soura.
Disclaimer: The views and opinions expressed in this article are the personal opinions of the author.
The facts, analysis, assumptions and perspective appearing in the article do not reflect the views of GK.