Addressing the Silent Epidemic: Urgent Global Action for Chronic Kidney Disease

Chronic kidney disease (CKD) is not just a medical issue; it is a global crisis demanding immediate attention. The recently published joint statement, Chronic Kidney Disease and the Global Public Health Agenda: An International Consensus, published in Nature Reviews Nephrology (1), underscores the severity of this burgeoning problem and advocates for swift action to combat its far-reaching consequences. This article was developed through a consensus among major nephrology societies, including ASN, the European Renal Association, and the International Society of Nephrology, to address the escalating global burden of CKD. Motivated by the rising prevalence of CKD and inconsistent screening practices, these societies aim to standardize guidelines, enhance early detection, and improve health care infrastructure. Their unified effort seeks to raise awareness, advocate for policy support, and ultimately improve CKD management and patient outcomes worldwide.

One of the key messages from the article is the escalating prevalence of CKD worldwide and its devastating impact on mortality, quality of life, and health care expenditures. CKD affects approximately 10% of the global population, with millions remaining undiagnosed and untreated. This should serve as a wake-up call for policymakers, health care practitioners, and society. Ignoring the rising tide of CKD will only exacerbate its toll on individuals and health care systems, particularly in low-income and low- to middle-income countries for which access to diagnosis and treatment is often limited. Moreover, it rightly emphasizes the socioeconomic disparities perpetuating unequal health outcomes among historically disadvantaged populations. Lack of access to optimal therapies further widens the gap, making it imperative to address not only the medical aspects of CKD but also the systemic inequalities that fuel its prevalence.

An essential call to action put forth the inclusion of kidney diseases in the World Health Organization's statement on major noncommunicable disease drivers of premature mortality. Countries face significant challenges in CKD screening and management due to limited awareness, inadequate screening programs, and health system constraints. Economic barriers, technological and infrastructure limitations, and epidemiological factors exacerbate the issue, and cultural, policy, research, and social determinants further complicate efforts. Addressing these challenges requires comprehensive strategies involving education, health care access, system improvements, and robust policy and research initiatives. This recognition would catalyze global efforts to raise awareness, establish guidelines, improve surveillance, and allocate resources for kidney health. By integrating CKD into the global health agenda, we can begin to chip away at the barriers that hinder progress in combating this silent epidemic (2).

Furthermore, the moral imperative to prioritize kidney health cannot be overstated, especially in light of the United Nations’ Sustainable Development Goals (SDGs). Addressing CKD aligns with several SDGs, including those related to reducing noncommunicable diseases, ensuring universal health coverage, and achieving health equity. By improving CKD screening and management, we can make significant strides toward these global health objectives, ultimately enhancing quality of life and reducing health care disparities worldwide. Excluding CKD from the global health agenda perpetuates inequities and undermines efforts to achieve health equity for all. Recognizing kidney diseases as major drivers of early mortality is not just a matter of policy; it is a moral obligation to address the needs of the most vulnerable members of society (3).

The article also outlines a roadmap for tackling the grand challenges of kidney health, including improving access to care, enhancing prevention strategies, and investing in research and development (Table). These efforts must be underpinned by a commitment to addressing social determinants of health and ensuring equitable access to resources for all individuals affected by CKD (4).

Table

Proposed roadmap for tackling the greatest kidney health challenges

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Urgent action is needed to confront the growing burden of CKD and prevent its catastrophic consequences. The time to act is now, and the stakes could not be higher. By heeding the call to prioritize kidney health, embracing global collaboration, and implementing comprehensive strategies, we can chart a course toward a healthier future for all. The recognition of CKD by the World Health Organization is not just a symbolic gesture; it is a pivotal step toward transforming the landscape of kidney care and safeguarding the well-being of future generations (5).