(Press-News.org) Preventable deaths caused by acute kidney injury (AKI) could be nearly eliminated in just 10 years, according to leading medical experts. This often forgotten condition - which affects around 13 million people every year and contributes to 1.7 million deaths annually - is preventable and can be treated for as little as $US150 per patient.
A major new Commission from The Lancet and the International Society of Nephrology (ISN) reports on an ISN initiative, launched in 2013, which calls for preventable deaths from AKI to be eliminated by 2025 (0by25). According to Professor Giuseppe Remuzzi, President of the ISN, and one of the Commission authors, "The ability to provide lifesaving treatments for acute kidney injury provides a compelling argument to consider therapy for it as much as a basic right as it is to give antiretroviral drugs to treat HIV, especially as care needs only be given for a short period of time in most patients." [1]
AKI, which causes an abrupt or rapid decline in kidney function, is a serious and increasingly common condition worldwide. In high-income countries, AKI often arises after major surgery and use of medicines which affect kidney function in hospitals, whereas in low- and middle-income countries (LMICs) it is mainly a community-acquired disease that affects young and previously healthy individuals, and is often associated with diarrhoea, infections such as malaria, and toxins (see table 5 page 8).
Complications include chronic kidney disease and end-stage renal disease that need dialysis and transplantation, resulting in high long-term costs. NICE estimates the yearly cost of AKI to the NHS in England to be between £434 million and £620 million per year, which is higher than the costs associated with breast cancer, or lung and skin cancer combined [2].
New estimates produced for the Commission suggest that 1 in 5 adults admitted to hospital worldwide develop AKI (see figure 3 page 6). But because most cases in LMICs are not recorded, this is likely to be only the tip of the iceberg in terms of the true public health burden of AKI in these regions, say the authors.
Despite most avoidable deaths occurring in LMICs where there are few resources to diagnose and treat AKI, the Commission shows that most cases of AKI are preventable, can be detected early, and are treatable with 1-2 weeks of peritoneal dialysis for as little as US$150. This type of dialysis can be done in most settings because it doesn't require electricity or water supplies.
The Commission sets out an achievable three-pronged strategy against AKI. First, to establish the true burden of AKI and include it on the global health agenda. Second, to raise awareness of AKI at all levels of national health systems and improve patient care based on the 5 Rs: risk (identifying high-risk individuals), recognition (prompt diagnosis), response (effective interventions), renal support (dialysis), and rehabilitation (see figure 1 page 3). And third, to persuade stakeholders, including governments and charities, of the economic merits of investing in a sustainable infrastructure. This could be done by framing AKI as a condition that disproportionately affects people during their economically productive years, and which can be treated at a reasonable cost.
While 0by25 might seem like an ambitious target, Commission co-author Professor Ravindra Mehta from the University of California San Diego Medical Center, USA, says, "We are confident that many of the preventive and therapeutic interventions against AKI can use existing infrastructure, advances in technology, and human resources across different regions. The remarkable accomplishment of the AIDS 3by5 initiative (3 million people with HIV on anti-retroviral treatment by 2005) in low-resource countries provides evidence that concerted efforts can lead to success in reducing the burden of devastating diseases. However, 0by25 will only be feasible if diagnostics and dialysis equipment and supplies are made available at low cost and if national health authorities can be encouraged to invest in sustainable infrastructure to address kidney disease." [1]
Writing in a Comment accompanying the Commission, Lancet Editor-in-Chief Dr Richard Horton and Senior Editor Philippa Berman say, "The evidence gathered [in this Commission] provides a firm foundation to establish a compelling human rights case for nephrology. [The authors]...have offered an achievable strategy to reach 0by25. The Lancet's commitment now is to work with the ISN to ensure accountability for the goals set out in the Commission--to monitor, review, and act to ensure progress towards 0by25."
The Commission will be presented at the World Congress of Nephrology in Cape Town, South Africa on March 13-17, 2015.
INFORMATION:
NOTES TO EDITORS:
[1] Quotes direct from authors and cannot be found in text of Commission.
[2] https://www.nice.org.uk/guidance/cg169
New estimates published in The Lancet indicate that at best only half of people worldwide needing kidney dialysis or transplantation to treat kidney failure in 2010 received it. This suggests that at least 2.3 million people may have died prematurely from kidney failure because they could not access this life-saving treatment.
The research shows that most of these preventable deaths occurred in China, India, Indonesia, Pakistan, and Nigeria, where less than a quarter of eligible patients receive treatment for kidney failure.
"The high cost of current dialysis techniques ...
SAN DIEGO -- Healthy young adults who don't consume caffeine regularly experienced greater rise in resting blood pressure after consumption of a commercially available energy drink -- compared to a placebo drink -- thus raising the concern that energy drinks may increase the risk of cardiac events, Mayo Clinic researchers found.
Results of the study will be presented Saturday, March 14, at the American College of Cardiology's 64th Annual Scientific Session in San Diego.
In this study, researchers alternately gave a can of a commercially available energy drink or a placebo ...
SAN DIEGO -- People exposed to prolonged periods of shortened sleep have significant increases in blood pressure during nighttime hours, Mayo Clinic researchers report in a small study of eight participants.
Results of the study will be presented Sunday, March 15, at the American College of Cardiology's 64th Annual Scientific Session in San Diego.
In this study, eight healthy, normal weight participants, ages 19 to 36, participated in a 16-day inpatient protocol, consisting of a four-day acclimation period followed by nine days of either sleep restriction (four hours ...
A study led by Massachusetts General Hospital (MGH) investigators suggests that bariatric surgery can significantly reduce the risk of asthma attacks - also called exacerbations - in obese patients with asthma. Their report, published online in the Journal of Allergy and Clinical Immunology, is the first to find that significant weight reduction can reduce serious asthma-associated events.
"We found that, in obese patients with asthma, the risk of emergency department visits and hospitalizations for asthma exacerbations decreased by half in the two years after bariatric ...
Media and popular culture might portray religion and science as being at odds, but new research from Rice University suggests just the opposite.
Findings from the recently completed study "Religious Understandings of Science (RUS)" reveal that despite many misconceptions regarding the intersection of science and religion, nearly 70 percent of evangelical Christians do not view the two as being in conflict with each other.
The research was presented by Rice sociologist Elaine Howard Ecklund today in Washington, D.C., during the American Association for the Advancement ...
Case Western Reserve researchers are part of an international team that has discovered that a common herpes drug reduces HIV-1 levels -- even when patients do not have herpes.
Published online in Clinical Infectious Diseases, the finding rebuts earlier scientific assumptions that Valacyclovir (brand name, Valtrex) required the presence of the other infection to benefit patients with HIV-1.
The result not only means that Valacyclovir can be used effectively with a broader range of HIV-1 patients, but also suggests promising new avenues for the development of HIV-fighting ...
Washington, D.C.-Two new papers from members of the MESSENGER Science Team provide global-scale maps of Mercury's surface chemistry that reveal previously unrecognized geochemical terranes -- large regions that have compositions distinct from their surroundings. The presence of these large terranes has important implications for the history of the planet.
The MESSENGER mission was designed to answer several key scientific questions, including the nature of Mercury's geological history. Remote sensing of the surface's chemical composition has a strong bearing on this and ...
Among the facts so widely assumed that they are rarely, if ever studied, is the notion that wider hips make women less efficient when they walk and run.
For decades, this assumed relationship has been used to explain why women don't have wider hips, which would make childbirth easier and less dangerous. The argument, known as the "obstetrical dilemma," suggests that for millions of years female humans and their bipedal ancestors have faced an evolutionary trade-off in which selection for wider hips for childbirth has been countered by selection for narrower hips for ...
WASHINGTON - A legal scholar and tobacco control expert says he has developed a research-based roadmap that allows for the immediate regulation of e-cigarettes.
Writing in the March issue of Food and Drug Law Journal, Eric N. Lindblom, JD, senior scholar at the O'Neill Institute for National and Global Health Law, says his proposal would minimize the threats e-cigarettes pose to public health while still enabling them potentially help reduce smoking.
"This approach could help to heal the current split in the public health community over e-cigarettes by addressing ...
New research led by University of York scientists highlights how poor connectivity of protected area (PA) networks in Southeast Asia may prevent lowland species from responding to climate change.
Tropical species are shifting to higher elevations in response to rising temperatures, but there has been only limited research into the effectiveness of current protected area networks in facilitating such movements in the face of climate change.
However, the new study, published in the journal Biological Conservation, focuses on the connectivity of the protected area network ...
