EKHA’s first article, “Reducing the costs of chronic kidney disease while delivering quality health care: a call to action” is published in the Nature Reviews Nephrology Journal, a peer-reviewed medical journal for nephrologists.
The article points out the substantial societal costs imposed by the treatment of Chronic Kidney Disease (CKD) and End-Stage Renal Disease (ESRD). Expenditure is highest for Renal Replacement Therapy (RRT), especially for in-hospital haemodialysis. Accordingly, a shift towards less expensive forms of RRT (peritoneal dialysis, home haemodialysis) or kidney transplantation should decrease financial pressure.
However, costs for CKD are not limited to RRT, meaning even if patients with CKD or ESRD could be given the least expensive therapies, costs would decrease only marginally. Therefore, a consistent and sustainable approach focusing on prevention should be adopted. Before a preventive strategy is favoured, however, authorities should carefully analyse the cost to benefit ratio of each strategy. Primary prevention of CKD is more important than secondary prevention, as many other related chronic diseases, such as diabetes mellitus, hypertension, cardiovascular disease, liver disease, cancer, and pulmonary disorders could also be prevented. Primary prevention largely consists of lifestyle changes that will reduce global societal costs and, more importantly, result in a healthy, active, and long-lived population. The article calls on nephrologists to collaborate closely with other sectors and governments to reach these aims.