International Consensus Statement Calls for Prioritization of Kidney Disease by the WHO

Christoph Wanner

Credit: European Renal Association

A landmark international consensus statement from a coalition of leading experts, stakeholders, and nephrology societies is sounding the alarm on the growing global burden of kidney disease and the need for its prioritization by the World Health Organization (WHO).¹

Led by the American Society of Nephrology, European Renal Association, and International Society of Nephrology, the consensus statement was published in Nature Reviews Nephrology and calls for kidney disease to be prioritized by the WHO as a major non-communicable disease driver of premature mortality and outlines several policy, advocacy, and implementation needs to alleviate its growing impact.¹

"Kidney disease is under-recognized and under-resourced. Recognizing the silent yet pervasive impact of kidney disease as a leading driver of NCDs, our three societies can mobilize joint efforts to save lives and enhance health outcomes globally. Through collaborative efforts, we can amplify awareness, allocate resources, and prioritize global kidney health in our pursuit of a healthier, more equitable future for all," Christoph Wanner, president of the European Renal Association, said in a press release.²

The consensus statement highlights the greater global prevalence of kidney disease compared to other non-communicable diseases currently prioritized by the WHO, including cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes. Investigators further cite the growing proportion of deaths due to kidney disease, noting the number of years of life lost attributed to chronic kidney disease (CKD) is predicted to rise by 100% between 2016 and 2040.¹

"In contrast to cardiovascular disease, stroke, and respiratory disease, CKD mortality rates have been on a troubling rise. Presently, kidney disease stands as the third fastest-growing cause of death worldwide, with deaths attributable to kidney disease surged by 50% from 2000 to 2019," Masaomi Nangaku, president of the International Society of Nephrology, explained in a press release.²

Additionally, investigators noted patients with CKD are at an increased risk of developing other non-communicable diseases and have a greater risk of infection, causing high mortality and symptom burden that can also translate to costly financial strain for patients. Often, this leads to a surplus of morbidity and mortality.¹

Despite kidney disease being common, deadly, and costly, public awareness of it is lacking, undermining efforts to mitigate risk factors and improve early diagnosis. The consensus asserts greater global recognition of kidney disease as a driver of premature mortality could encourage the widespread prioritization of strategies aiming to prevent the development and progression of kidney disease and support the development of more affordable and effective treatments.¹

Accordingly, the consensus makes several key recommendations to be addressed by the WHO regarding access to care, prevention strategies, care models, awareness and education, social determinants of health, funding and research, international coordination, and engagement with patient communities.¹

Specifically, investigators call for enhanced availability of affordable and accessible healthcare services, especially in resource-constrained settings, as well as the development of effective strategies for preventing CKD and acute kidney injury (AKI) that tailor interventions to local contexts. They also emphasize the need for implementing balanced, scalable, and sustainable models of care.¹

The consensus also highlights the importance of awareness campaigns for educating both individuals and primary care providers on early diagnosis and management of CKD, further pointing out the need to recognize and address social determinants of health that may disproportionately impact the burden of kidney diseases in certain communities.¹

Finally, investigators call for increased funding for research and development for new treatments, improving understanding of kidney diseases, and addressing global disparities in healthcare access and outcomes. They further cite the importance of collaborative efforts at the international level but also highlight the need to engage with patient communities to design patient-centric policies, programs, and services.¹

"This consensus statement marks a significant first step in recognizing the impact kidney diseases have on more than 850,000,000 people globally and the need to eliminate disparities in kidney health and achieve equity in kidney care for people from all walks of life. I believe that the World Health Organization (WHO) and governments worldwide will rise to meet this call to action," concluded Deidra Crews, MD, president of the American Society of Nephrology.²

References:

1. ^{Kidney disease: a global health priority. Nat Rev Nephrol (2024). https://doi.org/10.1038/s41581-024-00829-x}
2. ^{American Society of Nephrology. International Consensus Statement Published in Nature Reviews Nephrology Calls for Urgent Action to Address Chronic Kidney Disease on the Global Public Health Agenda. NewsWise. April 4, 2024. Accessed April 16, 2024. https://www.newswise.com/articles/international-consensus-statement-published-in-nature-reviews-nephrology-calls-for-urgent-action-to-address-chronic-kidney-disease-on-the-global-public-health-agenda}