[Written by Jorge Cerdá, MD, MS, FACP, FASN, FISN, Nephrologist with New York Nephrology and Dialysis Access Surgery, PC; Chief, Division of Internal Medicine, St. Peter’s Health Partners; Clinical Professor of Medicine, Albany Medical College.]
The kidneys keep our body chemistry in balance. Filters and tubules form functioning units called nephrons – approximately 1 million per kidney – that filter, purify and remove waste and excess fluid in about two quarts of urine a day. These units circulate and readjust our whole blood supply every two minutes.
Simultaneously, the kidneys keep blood pressure under control, help build healthy bones, manage fluid and electrolytes, control metabolism, and support the production of red blood cells. They are unquestionably some of the hardest-working organs in your body.
Approximately 850 million people worldwide are affected by kidney disease. One in three Americans are at risk for kidney disease, with one in 10 adults diagnosed with chronic kidney disease (CKD). While severity can vary, CKD is progressive and requires lifelong care. When kidneys suddenly fail and develop acute kidney injury (AKI), patients experience reversible but often severe disease, with elevated mortality, and often long-term kidney dysfunction.
Recognizing the global burden of kidney disease, World Kidney Day – celebrated March 14 this year – focuses on raising awareness of conditions affecting kidney health and their impact on quality of life and survival, while reducing the frequency and impact of kidney disease and its associated health problems.
People being treated for diabetes, hypertension, cardiovascular disease, and immune system abnormalities are at highest risk for kidney disease, and the impact on their overall health requires interdisciplinary collaboration. Not uncommonly, treatment of other diseases such as cancer may cause kidney injury requiring team management. Frequently, severe infection (sepsis) leads to acute kidney failure.
Often, persons affected by acute kidney disease during hospitalization are unaware or do not fully grasp the significance of their problem. Close monitoring and a team approach, including the physician, the patient, and the family are necessary for best short- and long-term outcomes, and to manage expectations and goals.
Persons affected by kidney disease and their families are now recognized as a central component in awareness, recognition, and recovery. The Acute Kidney Injury (AKI! Now) Initiative of the American Society of Nephrology (ASN) promotes recognition and team management of kidney disease, with the goal to improve short and long-term outcomes.
The Acute Kidney Injury (AKI) Toolkit, which was recently adopted as the worldwide procedure manual by the World Health Organization, was developed by an international team of kidney specialists, in collaboration with the International Society of Nephrology. The developing team was led by our group of Drs. Etienne Macedo from University of California San Diego, Andrew Lewington from Leeds Teaching Hospital, UK, and myself. The manual contains the recommendations for managing AKI around the world, with special emphasis on low-resource settings in low- and middle-income countries.
For more information on this program, visit the American Society of Nephrology at https://www.asn-online.org/ and the International Society of Nephrology at https://www.theisn.org/.
For more information on the treatment and management of kidney disease, visit the National Kidney Foundation at https://www.kidney.org/.
Happy World Kidney Day and National Kidney Month!
