ABSTRACT
Abstrac Living with chronic kidney disease (CKD) is associated with hardships for patients and their care-partners. Empowering patients and their care-partners, including family members or friends involved in their care, may help minimize burden and consequences of CKD related symptoms to enable life participation. There is a need to broaden the focus on living well with kidney disease and re-engagement in life, including emphasis on patients being in control. The World Kidney Day (WKD)Joint Steering Committee has declared 2021 the year of "Living Well with Kidney Disease" to increase education and awareness on the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to assess and address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care or to support labelling claims for medicines and devices. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care-partners should feel supported to live well through concerted efforts by kidney care communities including during pandemics.In the overall wellness program for kidney disease patients, the need for prevention should be reiterated. Early detection with prolonged course of wellness despite kidney disease, after effective secondary and tertiary prevention programs, should be promoted. WKD 2021 continues to call for increased awareness of the importance of preventive measures throughout populations, professionals, and policy makers, applicable to both developed and developing countries.
Resumen Vivir con unaenfermedad renal crónica (ERC) se asocia con dificultadestanto para lospacientescomo para suscuidadores. Empoderar a lospacientes y a suscuidadores, incluidoslosfamiliares y amigos que losasisten, minimiza la carga y las consecuencias de lossíntomas de la ERC y posibilitaparticiparenactividadescotidianas. Esnecesarioampliar el enfoque para lograrunabuenacalidad de vida para lospacientes con nefropatías y que puedanretomarsuvidadiaria, y hacerhincapiéen que estostengan el control. El ComitéDirectivo del Día Mundial del Riñón (DMR) ha declarado el 2021 el año de "Vivirbien con unaenfermedad renal" para aumentarlosconocimientos y generarconcienciaacerca de la importancia de empoderar al paciente y de que participenen las actividadescotidianas. Estoexige el desarrollo y la implementación de criterios de valoración de losresultadoscomunicadosporlospacientes para evaluar y enfocarseenáreas de la vidacotidianaen el cuidado. Podríacontarse con el aval de organismosregulatorioscomomedida de la calidad de cuidado o para darrespuesta a losreclamosacerca del etiquetado de medicamentos y dispositivos. Las agencias de financiamientopodríanlanzarconvocatorias para investigaciones que se centrenen las prioridades de lospacientes. Los pacientes con enfermedad renal y suscuidadoresdebenrecibirapoyo para llevarunabuenavida a través del esfuerzocoordinado de las sociedades de investigación renal, incluso, duranteunapandemia. Esprecisoreiterar la importancia de la prevenciónenlosprogramasintegrales de bienestar para pacientesrenales. Deben promoverse la deteccióntemprana con evoluciónprolongada del bienestar a pesar de la enfermedad renal luego de programas de prevenciónsecundarios y terciarios. El DMR 2021 siguefomentandouna mayor concienciaacerca de la importancia de las medidaspreventivasen la población, profesionales y legisladores, que se apliquenenpaísesdesarrollados y envías de desarrollo.
ABSTRACT
Objective: chronic kidney disease (CKD) is an increasing common problem in the world due to the exponential growth of diabetes mellitus, hypertension and other risk factors. The aim of this study is to investigate urinary abnormalities and risk factors for kidney disease in the general population. Methods: this study was performed from data collected during the annual World Kidney Day (WKD) campaigns, in Fortaleza, Ceará, Brazil, between 2009 and 2012. The population sought assistance spontaneously in stands placed in high people-traffic areas. Results: among 2,637 individuals interviewed, the mean age was 50.7±15.7 years and 53% were male. The main risk factors found were sedentarism (60.7%), obesity (22.7%) and smoking (19.8%). Blood pressure (BP) > 140x90 mmHg was found in 877 (33%). Increased BP was found for the first time in 527 cases (19.9%). Cardiovascular diseases were reported in 228 (8.6%). Diabetes was related by 343 (13%). Capillary blood glucose > 200 mg/dL was found in 127 (4.8%) and it was > 200 mg/dL for the first time in 30 (1.13%). Urinalysis was performed in 1,151 people and found proteinuria in 269 (23.3%). Proteinuria was most frequent in hypertension people (77.3% vs. 55.8%, p=0.0001), diabetes mellitus (22.7% vs. 15.2%, p=0.005) and elderly (42.1% vs. 30.7%, p=0.0007). Conclusion: risk factors for CKD are frequent in the general population. Many individuals had hypertension and diabetes and did not know this. It is important to regularly perform actions like WKD in order to early detect potential candidates for CKD. .
Objetivo: a doença renal crônica (DRC) é um problema crescente no mundo em razão do crescimento exponencial do diabetes mellitus, da hipertensão e de outros fatores de risco. O objetivo deste estudo é investigar alterações urinárias e fatores de risco para doença renal na população geral. Métodos: este estudo foi realizado a partir de dados coletados durante as campanhas anuais do Dia Mundial do Rim, em Fortaleza, Ceará, Brasil, entre 2009 e 2012. A população buscou atendimento espontaneamente nos stands montados em locais de alto tráfego de pessoas. Resultados: entre 2.637 indivíduos entrevistados, a média de idade foi de 50,7±15,7 anos, sendo 53% do gênero masculino. Os principais fatores de risco encontrados foram sedentarismo (60,7%), obesidade (22,7%) e tabagismo (19,8%). Pressão arterial (PA) > 140x90 mmHg foi encontrada em 877 casos (33%). Aumento da PA foi encontrado pela primeira vez em 527 casos (19,9%). Doenças cardiovasculares foram relatadas por 228 indivíduos (8,6%). Diabetes foi relatado por 343 indivíduos (13%). Glicemia capilar > 200 mg/dL foi encontrada em 127 casos (4,8%) e > 200 mg/dL pela primeira vez em 30 (1,13%). O exame de urina foi realizado por 1.151 pessoas, sendo encontrada proteinúria em 269 casos (23,3%). Proteinúria foi mais frequente em pessoas com hipertensão (77,3% vs. 55,8%, p = 0,0001), diabetes mellitus (22,7% vs. 15,2%, p = 0,005) e em idosos (42,1% vs. 30,7%, p = 0,0007). Conclusão: fatores de risco para DRC são frequentes na população geral. Muitos indivíduos tinham hipertensão e diabetes e não sabiam disso. É importante a realização de ações como o Dia Mundial do Rim com o objetivo de detectar precocemente potenciais candidatos à DRC. .
ABSTRACT
World Kidney Day on March 8th 2012 provides a chance to reflect on the success of kidney transplantation as a therapy for end stage kidney disease that surpasses dialysis treatments both for the quality and quantity of life that it provides and for its cost effectiveness. Anything that is both cheaper and better, but is not actually the dominant therapy, must have other drawbacks that prevent replacement of all dialysis treatment by transplantation. The barriers to universal transplantation as the therapy for end stage kidney disease include the economic limitations which, in some countries place transplantation, appropriately, at a lower priority than public health fundamentals such as clean water, sanitation and vaccination. Even in high income countries the technical challenges of surgery and the consequences of immuno-suppression restrict the number of suitable recipients, but the major finite restrictions on kidney transplantation rates are the shortage of donated organs and the limited medical, surgical and nursing workforces with the required expertise. These problems have solutions which involve the full range of societal, professional, governmental and political environments. World Kidney Day is a call to deliver transplantation therapy to the one million people a year who have a right to benefit.