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Don't be blind to kidney disease

It's Kidney Health Week! Read on to hear from Dr Shilpa Jesudason & Breonny Robson, as they encourage all primary healthcare workers to open their eyes to Chronic Kidney Disease (CKD), an often under-diagnosed condition that currently affects almost 2 million Australians.

 Chronic Kidney Disease (CKD) is a condition that tends to fly under the radar. This is despite it being a significant contributor to morbidity and mortality in the Australian population, with almost 2 million Australian adults having some degree of kidney damage. [1]

It’s Kidney Health Week! Kidney Health Australia’s ‘Don’t Be Blind to Kidney Disease’ campaign urges everyone to open their eyes to this highly undiagnosed condition and find out if they are the one in three at increased risk, making it the perfect time to look at how kidney disease is being managed in your practice.

 CKD is defined as the occurrence of kidney damage and/or reduced kidney function that lasts for three months or more. CKD usually develops over a number of years and, if detected early and managed appropriately, the otherwise inevitable deterioration in kidney function can be reduced by as much as 50 per cent [2].

Preventing CKD from developing or progressing is a key activity that primary care health professionals can address.

 Firstly, it is important to identify individuals at risk of CKD and manage their risk factors appropriately. Risk factors for CKD are:

  • Diabetes
  • Hypertension
  • Established cardiovascular disease
  • A family history of kidney failure
  • Obesity
  • Smoking
  • Aged 60 years or older
  • Aboriginal or Torres Strait Islander origin
  • A history of acute kidney injury (AKI)

 Early detection and referral saves lives and this year during Kidney Health Week, Kidney Health Australia is encouraging the public to find out if they are at risk of kidney disease. People identified as being at risk of CKD are encouraged to visit their GP and undergo a Kidney Health Check (blood test for eGFR, urine albumin / creatinine ratio, blood pressure check) every 1-2 years3.

 Key prevention activities for individuals at increased risk of kidney disease are to: manage their cardiovascular risk / blood pressure / diabetes appropriately, encourage lifestyle modification and provide the patient with resources and education to assist them with their self-management goals.

 For people diagnosed with CKD, halting further progression is vital. CKD is a major independent risk factor for cardiovascular disease, and for people with CKD, the risk of dying from cardiovascular events is up to 20 times greater than the risk of requiring dialysis or transplantation.4 Interestingly, the increased cardiovascular risk is noted from the time a patient first develops albuminuria, again highlighting the importance of early detection.

 First line management strategies include recommending lifestyle changes (SNAP – smoking, nutrition, alcohol, physical activity) and prescribing ACE Inhibitors or ARBs to lower blood pressure and slow the progression of albuminuria.3 CKD management information including CKD staging, colour-coded action plans, and referral guidelines can be found in the publication CKD Management in General Practice. [3]

Kidney Health Australia has a range of resources, education and support available for people living with kidney disease, as well as the health professionals who look after them. A key resource for people newly diagnosed with CKD is My Kidneys My Health, a free handbook and app designed to help people navigate their CKD diagnosis, and assist with self-management and support. Kidney Health Australia also produce a broad range of fact sheets to help patients understand kidney disease better.

 GPs and nurses working in Primary healthcare are often the first point of contact for people who are at risk of kidney disease and we would encourage them to access the CKD Management in General Practice handbook , the CKD-Go! App and to complete the online learning available free through ThinkGP.

 For more information on Kidney Health Week visit www.kidney.org.au/kidney-health-week

References

  • [1] Thomas, M.C. Early detection of patients with kidney disease. Nephrology 2007; 12, S37-S40
  • [2] Johnson DW. Evidence-based guide to slowing the progression of early renal insufficiency. Intern Med J 2004 January;34(1-2):50-7.
  • [3] Chronic Kidney Disease (CKD) Management in General Practice. Melbourne: Kidney Health Australia, 2015.
  • [4] Keith, DS, Nichols, GA et al. Longitudinal follow-up and outcomes among a population with chronic kidney disease in a large managed care organisation. Arch intern med 2004 March 22;164(6):659-63


Breonny RobsonBreonny Robson BMedSc
Breonny is the National Education Manager for Kidney Health Australia – a not-for profit organisation dedicated to improving health outcomes and quality of life for people living with kidney disease, their families and carers. In this role she is responsible for the delivery of national programs providing education and resources for both health professionals working in primary care and the patients they care for.
Breonny completed her Bachelor of Medical Science at Flinders University and has worked in the health industry for the last 15 years in roles spanning from health coaching, sales and marketing to education and project management. In her spare time she enjoys spending time with her family, and also doing a bit of sewing and gardening.



Breonny RobsonDr Shilpa Jesudason Dr Jesudason is a Senior Clinical Lecturer, University of Adelaide; Staff Specialist Nephrologist in General Nephrology, Transplantation and Obstetric Nephrology, at the Central and Northern Adelaide Renal and Transplantation Service (CNARTS) Royal Adelaide Hospital. She trained at the Royal Adelaide Hospital, Flinders Medical Centre and St Mary's Hospital Transplant Unit in London before returning in 2004 to undertake PhD studies in transplantation immunology at the Basil Hetzel Institute, Queen Elizabeth Hospital. Her current clinical and research interests include pregnancy-related issues in women with renal disease, including all stages of CKD, dialysis and transplant patients, living kidney donors and women with hypertension. She also chairs the CNARTS Clinical Research Group which leads a range of studies addressing patient-centred outcomes in CKD and dialysis patients. Dr Jesudason has been the Clinical Director at Kidney Health Australia since June 2017.