The American Society of Nephrology (ASN) is reinforcing what those of us in kidney care have been experiencing for years: There is too much focus on kidney failure rather than kidney health.
The COVID-19 pandemic put even more urgency on kidney health, as well as its disparities in diagnosis and treatment. In order to move from kidney disease to kidney health, ASN created a roadmap and rallying cry to mobilize the kidney care community and work toward a world without kidney diseases by embracing four priorities:
Intervene Earlier to prevent, diagnose, treat, coordinate care, and educate.
Transform Transplant and increase access to donor kidneys.
Accelerate Innovation and expand patient choice.
Achieve Equity and eliminate disparities.
ASN is launching a campaign that shares these learnings and engages the kidney professional community in achieving these goals. This campaign has four principles:
1 A Rallying Cry. “We're United 4 Kidney Health” captures the ambitious goal of the campaign: the embrace of early intervention and health over end-state treatment and diseases; the unity across kidney health professions and the powerful diversity of our patients and providers; and the four priorities that move us from kidney diseases to kidney health.
2 Kidney Professionals Telling the Story. They are the eyes, ears, and mouthpiece for an often-disadvantaged community and hidden diseases. They share their stories, their passion, and their progress. I was proud to join my colleagues from across the nation, including Mukta Baweja, MD; Eugene Lin, MD, MS, FASN; Alejandro Diez, MD, FASN; and Sri Lekha Tummalapalli, MD, MBA, to share this important work. Through this campaign, we look forward to joining with many other members of the kidney health community to tell our stories.
3 Personal and Group Commitment. ASN wants to demonstrate personal commitment to this effort and understand that this will take the entire kidney care community to be successful. Kidney care professionals are encouraged to go to 4KidneyHealth.org to join the movement in supporting the four priorities needed to reach a future without kidney diseases.
4 Substance and Action. We are expanding our network over time, collecting best practices to share with the community, and activating desired behaviors that drive progress.
As members of the kidney health community, we have the future in our hands. ASN has built this foundation, a powerful launching pad, but now we need to put a man on the moon. I get most excited about the promise of where we can go from here, leaving behind old ways of doing things that no longer serve us and our patients. However, these priorities can only be accomplished if we all work together. Indeed, kidney health is foundational to the health of the rest of the body: to create homeostasis, balance. Kidneys are complex and essential, and we need to attract the best and brightest minds to advance the field.
Unfortunately, we face a workforce problem in nephrology. And simply relying on the stereotype of the nephrologist as “the smartest doctor in the hospital” is an uninspiring and reductive trope that fails to capture the imagination of many young physicians today. After all, medical students and residents are more than just “smart”: They are deeply committed to advancing research and discovery, innovative medical education, and the passionate pursuit of justice through advocacy and equity. They are committed to all these pursuits, and we should be, too.
As a physician-advocate, the campaign's goal to “achieve equity and eliminate disparities” resonates with me, my patients, and many of the young people considering and entering nephrology today. Historically excluded communities are disproportionately affected by kidney diseases and kidney health disparities, including racial and ethnic minorities, houseless persons, and those who face socioeconomic challenges. Kidney health education and advocacy are key weapons in the arsenal of the kidney health professional: They are every bit as potent as the latest pharmaceutical or therapeutic device. Reaching communities where kidney health disparities are ravaging the population is one of our field's greatest charges. In doing so, we can combat the narrative of hopelessness in the face of kidney disease and expand awareness, acceptance, and adherence in the promotion of kidney health.
That links directly to another goal: “transform transplant and expand access to donor kidneys.” The single biggest thrill I have as a pediatric nephrologist is when I have the privilege of telling the parents of a child living with kidney failure that they will receive the gift of life—an organ donation. Not only is it important to expand opportunities to receive this gift, but increasing opportunities for health-disparate communities is a priority of nephrologists worldwide. Focused outreach to minority and health-disparate communities and exercising our platform as trusted messengers to combat medical misinformation are crucial tools for the 21st century nephrologist.
“Intervening earlier” is essential to promote “kidney health” rather than “kidney diseases.” Coordinating care with other healthcare providers is one of the most exciting aspects of my job, especially working in teams to care for patients referred to me. But today, our impact is limited in early intervention. Nephrology needs new approaches, specifically accelerated innovation so patients have meaningful choices: In too many cases of kidney disease today, our ability to intervene early is limited in impact because we don't have a fix. I am excited to see the remarkable pace of research and discovery taking place in basic, translational, clinical, and community-engaged research programs throughout the field, and I am optimistic that our impact will grow in the decades ahead.
I hope the kidney health community is as excited as I am for nephrology's future. I invite everyone to join this movement, make progress with these four priorities, and move society toward a world without kidney diseases.