Friday, May 31, 2024 | 05:56 WIB

World Kidney Day, bridging knowledge gap to better kidney care


IO – This year’s World Kidney Day theme is “Kidney Health for All: Bridge the Knowledge Gap to Better Kidney Care”. It emphasizes the equalization of kidney health services and the importance of bridging the knowledge gap, for better kidney health services. 

Globally, chronic kidney illness is the 12th highest cause of death, causing 4.6% of global deaths in 2017. This figure is expected to continuously increase, and chronic kidney illness is expected to rise to become the 5th highest cause of death by 2040. 

In Indonesia, the prevalence of chronic kidney illness increases each year. 2018 Basic Health Research data shows that the prevalence of chronic kidney illness is 0.38%. 2020 data from the Society of Nephrology Indonesia (Perhimpunan Nefrologi Indonesia – “Pernefri”) register shows that the cumulative incidence of patients undergoing hemodialysis is 61,786, and while the cumulative prevalence amount is 130.931. 

Left untreated, chronic kidney illness may well worsen into kidney failure. The primary causes of chronic kidney illness – and indirectly, kidney failure – are hypertension and diabetes. The high intensity of kidney failure means that it is not just a burden for the patient and their family, but it is also a burden to the State because the National Health Security (BPJS Kesehatan) expenditure for kidney illness is quite high. 

Indonesia is currently facing the triple burden of disease: new emerging and re-emerging infections such as Covid-19, communicable diseases, and incommunicable diseases. Worse, the incidence of each of the three tends to increase year after year. If we analyze our health expenditures, we see that Indonesia is still mostly focused on curative efforts. Even though incommunicable diseases are entirely preventable with a healthy lifestyle, their incidence continues to increase, on a rise since 2010. 

“We need to continue suppressing incommunicable disease incidence in order to be able to achieve our national health development targets, which are part of the 2030 SDG targets,” said dr. Imran Agus Nurali, Sp.KO, Ministry of Health’s Director of Health Promotion and People’s Empowerment, in a webinar held jointly by Pernefri, BPJS Kesehatan, and Fresenius Medical Care, Wednesday (9/3/2022). 

Advanced Stage 

Data shows that at least one third of chronic kidney illness patients are not aware of their illness, how the illness may develop, and possible therapies in case of kidney failure. Kidney illness is insidious: it generally shows no symptoms, and patients will only feel something to complain about in an advanced stage. 

“Lack of knowledge about kidney health is possibly the biggest cause of lateness in treatment, as patients tend to visit us in advanced stages. This is sad, as kidney problems are preventable by controlling risk factors, obtaining early diagnosis, and performing optimal treatment to prevent patients from degenerating into kidney failure,” said dr. Aida Lydia Sutranto, Sp.PD, KGH, PhD., Chairwoman of Pernefri. 

During the same event, BPJS Kesehatan’s President Director Prof. dr. Ali Ghufron Mukti, M.Sc., Ph.D., stated that patients can obtain access to a facility or Continuous Ambulatory Peritoneal Dialysis (CAPD) therapy through the national health security scheme. “We also cover kidney transplant costs up to IDR 378 million, because transplants tend to show better results than either hemodialysis or CAPD. Patients can get these services online to avoid prolonged queuing in health facilities,” he said. 

However, dr. Aida warns that even though all kidney failure patients may potentially get transplants, there are factors that must be considered. These include: whether the candidate kidney donor will remain healthy after a kidney donation or not, whether there is tissue compatibility between the patient and the candidate donor, and whether the patient is capable of enduring a transplant or not (among others, they must have no comorbidity and no heart function disabilities). (est)


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