The 14th of March marks World Kidney Day – an annual event dedicated to spreading global awareness of kidney health. Some 850 million people worldwide are believed to be living with some form of kidney disease – more than double the number of people living diabetes, and twenty times the number of people affected by cancer. It is estimated that between 6 and 17% of South Africans have some degree of permanent kidney impairment, termed “chronic kidney disease” or CKD. High rates of diabetes, high blood pressure, and HIV in South Africans may mean that the actual number of people living with CKD may be much higher than these estimates suggest.

The theme for World Kidney Day 2024 is “Kidney Health for All”. Early detection of CKD is important if kidney health is to be maintained. Since many cases of CKD are asymptomatic until the kidney damage is severe, all people living with diabetes, hypertension, HIV, or those with a family history of kidney disease, should be regularly tested for CKD so that treatment can be started at an early stage to slow further deterioration. General practitioners and primary health care nurses are vital in screening for CKD. A simple blood test measuring kidney filtration function (the eGFR) combined with a urine test for protein and a blood pressure measurement can reliably diagnose CKD and provide information on the severity of kidney function impairment.

Control of blood pressure and, in diabetics, of blood sugar levels, combined with a healthy lifestyle including not smoking, regular exercise, and avoidance of drugs which can harm the kidney, are important components of the management of CKD. Several new drugs have been developed which substantially reduce the risk of worsening CKD in those living with the condition. Many cases of CKD can be very successfully managed by general practitioners, but more severe levels of CKD should be seen by a nephrologist (kidney specialist). Current guidelines recommend that patients with an eGFR below 60 should preferably see a nephrologist, whilst those with an eGFR below 30 should definitely see one of these specialists. High levels of protein detected in the urine, or rapidly worsening CKD, are additional reasons for referral.

Care of people living with advanced CKD requires a multidisciplinary team comprising a nephrologist, general practitioner, dietician, and preferably a social worker or psychologist and a healthy start dialysis nurse practitioner. In many cases, worsening of CKD can be slowed, but it is usually not possible to stop this process completely. For some people, CKD may progress to kidney failure, also sometimes known as “end stage kidney disease”. At this stage, the kidneys are no longer able to maintain health and quality of life. Untreated kidney failure is fatal, but modern therapies such as dialysis and kidney transplantation allow people with kidney failure to live normal, active lives.

For those wanting to know more about CKD, the Facebook page of the National Kidney Foundation of South Africa (NKFSA) which hosts a number of educational YouTube videos on the kidney and on kidney diseases including CKD.

Any further WKD 2024 material can be found at:  https://www.worldkidneyday.org/2024-campaign/