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An Integrated Approach to Slow Down Chronic Kidney Disease Progression

Apr 01 , 2024 | 2 min read

Chronic kidney disease (CKD) poses a considerable global health challenge, impacting approximately 10% of the global population and ranking as the 12th leading cause of mortality worldwide.

In India, CKD is also on the rise due to factors like an ageing population, high rates of diabetes and hypertension, limited healthcare access in rural areas, and environmental issues such as air pollution and inadequate sanitation.

It is estimated that about 10% of the Indian population is suffering from some form of kidney disease.

Also, out of approximately 100 million Indians afflicted with diabetes, close to 40 million have associated kidney disease. All these can potentially lead to an advanced stage of kidney disease, leading to significant health and economic burdens.

Needless to say, the answer to the problem lies in its prevention. Addressing this escalating burden requires a collaborative, multidisciplinary holistic approach focusing on preventive measures, early detection, and retarding the disease progression.

Also Read: Lowering the Risk of Chronic Kidney Disease

Lifestyle modifications such as dietary interventions, weight management, and physical activity play a massive role in slowing the progression of the disease & improving overall quality of life. Protein restriction, Mediterranean Diet adoption, and increased fruit and vegetable intake are some of the recommended dietary approaches. It is suggested that CKD patients should avoid all recreational drug use, quit smoking, and limit alcohol intake. Individuals should aim for 150 minutes of moderate-intensity activity weekly or 75 minutes of vigorous activity. Mind-body interventions such as relaxation techniques, spiritual healing/prayer, laughter therapy, yoga, and meditation, once classified as complementary and alternative medicine, have now gained mainstream acceptance, along with support groups and cognitive-behavioural therapy.

Till recently, there were not enough weapons in our armamentarium to mitigate the rate of progression of CKD. However, the availability of some promising agents in recent years has brought in a lot of hope for those suffering from CKD.

Blood pressure and glycemic control are pivotal in slowing the progression of CKD, with personalized targets and non-pharmacological interventions recommended. Innovations in medical management leading to the introduction of drugs such as SGLT-2 inhibitors and angiotensin receptor-neprilysin inhibitors have demonstrated cardio-renal protection. GLP-1 receptor agonists have shown effectiveness in improving kidney outcomes. The newer mineralocorticoid receptor antagonists have shown promise in slowing CKD progression beyond traditional angiotensin-converting enzyme inhibitors or angiotensin receptor blockers.

Precision medicine tailors CKD treatments to individuals' genetics, lifestyle, and disease traits. Remote monitoring and telemedicine facilitate early complication detection and enhance disease management through regular patient-provider communication. Emerging techniques, artificial intelligence and machine learning, analyze data to predict CKD progression, enabling personalized risk assessment and treatment optimization.