world kidney day falls on Thursday March 12th 2020. World Kidney Day
is celebrated annually to continue to raise awareness of chronic kidney disease
and its increasing burden worldwide. The theme of the 2020 campaign is to
highlight the importance of preventative measures to avert the onset and
progression of kidney disease.
What is Chronic Kidney Disease (CKD)?
CKD is a
non-communicable disease in which there is a progressive loss in kidney
function over time. It includes any conditions that damage the kidneys,
decreasing their ability to function.
Function of the kidneys: The kidneys perform multiple functions within
the body including critical regulation of the body’s salt, potassium and acid
content, removal of waste products and drugs from the body, release of hormones
regulating blood pressure and production of red blood cells as well as
producing the active form of vitamin D that is necessary for strong and healthy
functional units within the kidneys are the nephrons. Each kidney contains
around 1 million nephrons. Damage to these nephrons causes them to stop
functioning. If just a few are damaged then the remaining healthy nephrons can
compensate, however, if damage continues to occur then eventually there will be
an insufficient number of healthy nephrons that can continue to properly filter
blood. Beyond a certain point chronic kidney disease can develop into kidney
failure, which affects the whole body and can be life threatening.
1 in 10 adults worldwide, that’s equivalent to around 850 million people. By
2040, CKD is projected to become the 5th most common cause of years
of life lost with a very high economic burden for treatment of end stage
disease- dialysis and transplantation in high income countries cost 2-3% of
annual healthcare budget on under 0.03% of population. In low and middle income
countries many people do not have access to such lifesaving treatments.
main causes of CKD are diabetes and high blood pressure, which are responsible
for around 2/3 of cases. Less common conditions include inflammation or
infections within the kidneys, long term blockage to the urinary tract (e.g.
kidney stones or enlarged prostate) and inherited conditions such as polycystic
kidney disease. The majority of individuals with early stage CKD do not have
any obvious symptoms and may appear completely healthy, but CKD increases a person’s risk of premature death from
associated cardiovascular disease i.e. heart attacks and strokes, regardless of
whether individuals ever develop kidney failure. However, if CKD is detected early and managed appropriately, the
deterioration in kidney function can be slowed or even stopped, and the risk of
associated cardiovascular complications can be reduced. Thus the theme for World Kidney Day
this year is to raise awareness and encourage people to check if they are at
risk of developing kidney disease.
What are the current treatment options for CKD?
currently no cure for CKD. There are however many options to slow or halt the
progression of the disease at the early stages, such as lifestyle modifications
including proper diet, exercise, no smoking as well as medications that may
help to maintain the critical balances in the body that the kidneys would
normally control, for example blood pressure and cholesterol levels. For end
stage renal disease ESRD, when the kidney stop functioning, long term dialysis (removal
of waste and excess fluids by machine) or transplantation are the main
Transplantation and overcoming immune rejection
is considered the best treatment option as it has the potential to be a one
time “cure”, however there are issue of availability of a suitable donor and
the possibility of immune rejection of the new kidney by the host immune
system. Work done by the ReSHAPE consortium, an EU funded project headed by
Prof. Reinke from the Charité Universitätsmedizin Berlin (https://www.reshape-h2020.eu/home), could potentially solve the problem of graft
rejection or the need to take immunosuppressive drugs for the rest of the patient’s
lifetime. The ReSHAPE consortium are focused on developing regulatory T cell (Treg)
therapy to overcome undesired autoimmunity, among other undesired Immune/Inflammatory
reactions, to reshape the immune response and if successful allow future
transplant patients to live a life free of a complex immunosuppressant
A role for stem cell treatment for kidney
there are no stem cell therapies for kidney disease, however it is an active
area of research. The kidneys are an incredibly complex organ and damage to the
kidney can affect many different cell types. To find out more about the
potential future role of stem cells in restoring kidney function please visit
the website below.
Accelerating the development and increasing
accessibility to life saving therapies
The aim of
the RESTORE large-scale research initiative
is to promote and support the development of Advanced Therapies such as Treg
therapy or future stem cell therapies and to accelerate their path to the
market whilst ensuring these treatments are accessible to all patients in need.
To do this, RESTORE is striving to build a
European ecosystem for Advanced Therapy development for the benefit of
patients, society and the wider European economy.
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