World Kidney Day and early detection of Kidney Disease

An estimated 40,000 people in the Mid West are living with Chronic Kidney Disease (CKD), and the region is home to one of the busiest kidney programmes in the country. But we must do more, writes Prof Austin Stack, Consultant Nephrologist, University Hospital Limerick, who says the key goal is early detection and intervention through a national screening programme for at-risk groups.

FOR PATIENTS living with kidney disease, World Kidney Day, the second Thursday of March, is a hugely important day, a means of raising awareness of and reducing the impact of kidney disease and associated health problems. University Hospital Limerick (UHL) will join the 2024 global efforts, this year highlighting the promotion of long-term kidney health through early detection of kidney disease.

UHL has one of the busiest kidney programmes in the country. At the end of 2023, our team looked after 277 patients treated with dialysis and 147 kidney transplants. While our goal is to provide comprehensive care that will give patients the best possible outcome and quality of life, the challenge for the entire health system is significant, as the number of patients who develop kidney failure continues to grow.

Our multidisciplinary clinical teams provide specialist care for people suffering from all types of kidney disease and at risk of kidney failure. With the latest investigations and treatments, we aggressively tackle the main causes of CKD, such as hypertension and diabetes, in partnership with GPs and other medical specialists. We also screen for and manage patients with less common causes, including polycystic kidney disease, glomerulonephritis, and many genetic causes.

But we must do more.

As many as one in 10 people in Ireland have some form of chronic kidney disease (CKD). We estimate that 40,000 people in the Mid West region be living with CKD, many of whom may be unaware

And that’s why the message on World Kidney Day 2024 is so powerful in its simplicity—the hopeful message that early detection of kidney disease protects long-term kidney health.

Collaborative research

In collaboration with the University of Limerick, the UHL team is leading a major research programme to reduce the burden of kidney disease and its complications. Our latest research – available here - has shown that the older we get, the more common CKD is, affecting more than 1 in 7 persons in Ireland over the age of 75. We show that CKD is extremely common in people with specific chronic conditions especially heart disease, diabetes, and hypertension. We have also discovered that CKD is very common in patients with cancer and obesity, and those who are less well off- holders of a medical card or GP card. These are easily identifiable groups who are at a very high-risk for CKD.

Need for a National Kidney Disease Surveillance System

Perhaps our most important finding is the identification of specific at-risk patients who would benefit from early screening and early intervention.

The good news is that kidney disease can now easily be detected in at-risk patients with a simple blood and urine test, either in primary or secondary care.

The other good news is that new treatments are available to slow or prevent the deterioration to kidney failure, offering new hope to the thousands of patients living with CKD.

There is an enormous opportunity to embed a surveillance programme in the Irish health system to screen high-risk groups for early signs of kidney damage. Later this year, CKD will be added to the HSE’s Chronic Disease Management (CDM) Programme, a hugely significant step forward for the improvement of kidney health here in the Mid-West and across the entire country.

Conclusion

This World Kidney Day presents a huge opportunity for people all over Ireland to ask themselves a key question—“Are your kidneys OK?”

Early detection of kidney disease means a greater opportunity for investigation and treatment. It’s a no brainer! Supporting this with the establishment of a National Kidney Disease Surveillance System to support screening, assessment of quality of care, and monitoring effectiveness of interventions, is now the key goal.

Professor Austin Stack is a Consultant Nephrologist at University Hospital Limerick, the Foundation Chair of Medicine at the School of Medicine, University of Limerick, and lead investigator at the National Kidney Disease Surveillance System (NKDSS).