World Kidney Day 2014: increasing awareness of chronic kidney disease and aging

*Corresponding author: Prof. Hamid Nasri, Department of Nephrology, Division of Nephropathology, Isfahan University of Medical Sciences, Isfahan, Iran. Tel: +98 311 220 8081, Fax: +98 311 223 5043, E-mail: [email protected] Last year, the International Society of Nephrology (ISN) and the International Federation of Kidney Foundations (IFKF), focused the World Kidney Day (WKD) of 2013 on acute kidney injury (1). In 2014 the WKD, however will focus on increasing awareness of chronic kidney disease and aging. WKD is a joint initiative of ISN and IFKF. WKD is a global health awareness campaign focusing on the importance of renal disease and reducing the frequency and impact of kidney disease and its associated health problems worldwide (1). The campaign is celebrated each year on the second Thursday of March in many countries (1). The term acute kidney injury was suggested to reflect the wide spectrum of traditional acute kidney failure. Acute kidney injury is particularly common in hospitalized individuals and its presence confers an increased risk of subsequent chronic kidney disease, increased hospital length of stay, and a higher risk of death (1,2). However, the impact of acute renal injury on the progression of chronic kidney disease is not well understood. Indeed, acute kidney injury can cause end-stage kidney failure directly, as well as increase the risk of developing incident chronic kidney disease or worsening progression of underlying chronic kidney disease (1-3). Furthermore, the duration, severity and frequency of acute kidney injury appear to be important predictors of poor patient outcomes. In addition, chronic kidney disease is an important risk factor for the development of acute kidney injury (2-4). Various studies provide the clinical findings and the bidirectional nature of the association between acute kidney injury and chronic kidney disease. Chronic kidney disease is a long-term condition and defined as the slow loss of renal function over time (1-3). Over the last decade, interest in the risk factors, incidence, rate of progression, and clinical outcomes of chronic kidney disease has been increasing as a result of high prevalence and increasing awareness of CKD. In the early stages of the disease process, patients with chronic kidney disease frequently experience no symptoms at all (2-5). However, even in the absence of symptoms, chronic kidney disease negatively affects various organs, raises the risk of cardiovascular events, can progress to end-stage kidney failure, and increases the risk of hospitalization and death (6,7). Worldwide there is an increasing prevalence of end-stage kidney disease (2-5). The rise in prevalence of end-stage kidney disease continues in spite of at least two decades of intensified kidney-protection modalities, consisting of optimal hypertension control, acceptable glycemic control in diabetics, smoking cessation, and the wide use of renin-angiotensin-aldosterone system (RAAS) blockade in both diabetic and non-diabetic CKD (1-5). The current thinking is that chronic kidney disease progresses to end-stage kidney failure or death at an increasing rate. Indeed, except for early premature cardiovascular death, progression from kidney parenchymal injury to end-stage kidney disease is the final common pathway for chronic nephropathies, which seems to be largely independent of the initial renal insult. The most http://journalrip.com DOI: 10.12861/jrip.2014.02