Kidney health for everyone everywhere - from prevention to detection and equitable access to care

The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual healthcare budget in high-income countries. However, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions - be it primary, secondary, or tertiary. This article focuses on outlining and analyzing measures that can be implemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, management of co-morbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to proliferate the preventive approach. While national policies and strategies for non-communicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management, and treatment are often lacking. Hence, there is an urgent need to increase the awareness of preventive measures throughout populations, professionals, and policy makers.

Chronic kidney disease in disadvantaged populations

The increased burden of chronic kidney disease (CKD) in disadvantaged populations is due to both global factors and population-specific issues. Low socioeconomic status and poor access to care contribute to health care disparities and exacerbate the negative effects of genetic or biological predisposition. Provision of appropriate renal care to these populations requires a two-pronged approach: expanding the reach of dialysis through development of low-cost alternatives that can be practiced in remote locations, and implementation and evaluation of cost-effective prevention strategies. Kidney transplantation should be promoted by expansion of deceased donor transplant programs and use of inexpensive, generic immunosuppressive drugs. The message of World Kidney Day 2015 is that a concerted attack against the diseases that lead to end-stage renal disease, by increasing community outreach, better education, improved economic opportunity, and access to preventive medicine for those at highest risk, could end the unacceptable relationship between CKD and disadvantage in these communities.

Lymphocyte subpopulations from patients with cervical uterine carcinoma undergoing radiation therapy.

Se estudio un grupo de 27 pacientes con cancer cervico uterino que estaban recibiendo tratamiento convencional con radioterapia externa (Co). El grupo fue dividido en subgrupos, de acuerdo a la dosis de radiacion a tumor aplicada hasta el momento del estudio. Se cuantifico subpoblaciones de linfocitos T, B, Teast y Tg a las pacientes mediante la tecnica de rosetas.Los porcentajes de la subpoblacion de linfocitos T con receptor para Fc de IgG (Tg) del grupo de pacientes se encontraron significativamente mas elevados que los hallados en un grupo de 28 individuos sanos.Ademas, los valores porcentuales de linfocitos Tg se encontraron significativamente mas elevados en aquellas pacientes que recibieron una dosi mayor de 1000 rads

El cancer como enfermedad ambiental. / Cancer as environmental discase

Se analiza la relacion primordial entre factores inherentes al huesped y elementos extrinsecos existentes en el ambiente. Se insiste, sobre todo, y esto es la finalidad fundamental de este trabajo, que los elementos ambientales, en su mayoria denominados cancerigenos, son tan solo elementos precanceringenos que han de ser potencializados por el huesped, o sea por el individuo a quien llegan. Es introducida en esta comunicacion la denominacion de "cancerigeno discreto", complejo quimico que finalmente es capaz de producir la mutacion nuclear origem de la cepa cancerosa. Es tambien introducida la idea de "galaxias cancerigenas", complejo en el que colaboran elementos intrinsecos y extrinsecos, llegandose a la conclusion de que el cancer no es una enfermedad ambiental, por lo que razona el trabajo, pero que tambien puede ser punto de partida de todo un proceso de cancerizacion