What We Know vs. What We Do: The Kidney Health Paradox
🚨 CKD treatment gap, More than 850 million people worldwide suffer from chronic kidney disease (CKD), which, if left untreated, leads to kidney failure and increased mortality. Despite the availability of effective treatments, many patients remain undiagnosed, and those diagnosed do not always receive the appropriate care.
💡 Key Questions:
- Why is early detection of kidney disease so low?
- Why are effective treatments underprescribed?
- What barriers prevent patients from receiving proper care?
Let’s explore practical solutions and real-world cases to address these gaps.
🔬 1. The Lack of Early Detection in CKD
🛑 Most Patients Are Unaware They Have Kidney Disease
📌 According to the 2019 Global Burden of Disease Study, kidney disease is the 7th leading cause of death globally.
📌 However, 80-95% of patients remain unaware of their condition until it reaches an advanced stage.
CKD Awareness vs. Treatment Implementation
- Awareness rate in early CKD stages: <20%
- Over 60% of CKD diagnoses occur at Stage 3 or later
- 30% of cases are diagnosed only after kidney failure (Stage 5)
Missed Opportunity for Early CKD Diagnosis
✔ A 40-year-old office worker, Mr. A
- Recently experienced fatigue and rising blood pressure
- A routine health check revealed an eGFR of 50 mL/min/1.73㎡
- Already in Stage 3 CKD → Had he been tested five years earlier, lifestyle modifications and medications could have slowed disease progression
2. CKD treatment gap : Why Are Effective Medications Underused?
🚨 Low Prescription Rates for Proven CKD Treatments
✅ Medications that provide kidney protection:
| Medication Class | Example Drugs | Benefits | Challenges |
|---|---|---|---|
| RAS Inhibitors | Losartan, Enalapril | Kidney protection, blood pressure control | Low prescription rates |
| SGLT2 Inhibitors | Dapagliflozin, Empagliflozin | Slows kidney decline, cardiovascular benefits | High cost, insurance issues |
| Mineralocorticoid Receptor Antagonists | Finerenone | Kidney and heart protection | Risk of hyperkalemia |
🚨 Current Prescription Rates:
- ACE inhibitors/ARBs: Only 40-70% of eligible patients receive them
- SGLT2 inhibitors: Less than 10% of CKD patients are prescribed these life-saving drugs
📌 Why is this happening?
| ✔ Lack of awareness among primary care providers |
| ✔ Limited access due to insurance restrictions and high costs |
| ✔ Concerns about polypharmacy (multiple medications) |
- RAS inhibitors usage increases in advanced CKD stages but remains suboptimal
- SGLT2 inhibitor prescription remains below 10% despite proven benefits
📌 🔎 Research Highlight: The Benefits of SGLT2 Inhibitors
The 2022 DAPA-CKD study found that SGLT2 inhibitors reduce kidney function decline by 39% in CKD patients.