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Patients with chronic kidney disease (CKD) frequently experience unpleasant symptoms. These can be gastrointestinal (constipation, nausea, vomiting and diarrhoea), psychological (anxiety and sadness), neurological (lightheadedness, headache and numbness), cardiopulmonary (shortness of breath and oedema), dermatological (pruritus and dry skin), painful (muscle cramps, chest pain and abdominal pain) or involve sexual dysfunction, sleep disorders and fatigue. These symptoms often occur in clusters, with one of them as the lead symptom and others as secondary symptoms. Uraemic toxins (also called uremic toxins) are often considered to be the main cause of CKD-associated symptom burden, but treatment of uraemia by dialysis often fails to resolve them and can engender additional symptoms. Indeed, symptoms can be exacerbated by comorbid conditions, pharmacotherapies, lifestyle and dietary regimens, kidney replacement therapy and ageing. Patients with kidney disease, including those who depend on dialysis or transplantation, should feel actively supported in their symptom management through the identification and targeting of unpleasant symptoms via a tailored palliative care approach. Such an approach may help minimize the burden and consequences of kidney disease, and lead to improved patient outcomes including health-related quality of life and better life participation.

Living with chronic kidney disease (CKD) is associated with hardships for patients and their care partners. Empowering patients and their care partners, including family members and friends involved in their care, may help minimize the burden and consequences of CKD-related symptoms to enable increased life participation. There is a need to broaden the focus on living well with kidney disease and reengagement in life, including emphasis on the patient being in control. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of “Living Well with Kidney Disease” in an effort to increase education about and awareness of the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to assess and address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care or to support labeling claims for medicines and devices. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care partners should feel supported to live well through concerted efforts by kidney care communities, including during pandemics. In the overall wellness program for patients with kidney disease, the need for prevention should be reiterated. Early detection with prolonged course of wellness despite kidney disease, after effective secondary and tertiary prevention programs, should be promoted. WKD 2021 continues to call for increased awareness of the importance of preventive measures across populations, professionals, and policy makers, applicable to both developed and developing countries.

Tamilnad Kidney Research Foundation (TANKER Foundation) which was established in 1993 to support kidney disease related care to underprivileged people. It has now eleven dialysis units in the state of Tamilnadu, India. COVID-19 pandemic has put enormous challenges for the dialysis staff. Here we describe how we face the challenges from March 2020 till now without interrupting or closing down the dialysis units. The no of dialysis staff who have got infected are 21% which required only home quarantine and symptomatic remedies. Our experience can be emulated by other charity organization which provide kidney care.

For the World Kidney Day Steering Committee Kidney disease is a global public health problem that affects more than 750 million persons worldwide. The burden of kidney disease varies substantially across the world, as does its detection and treatment. Although the magnitude and impact of kidney disease is better defined in developed countries, emerging evidence suggests that developing countries have a similar or even greater kidney disease burden. In many settings, rates of kidney disease and the provision of its care are defined by socioeconomic, cultural, and political factors, leading to significant disparities in disease burden, even in developed countries. These disparities exist across the spectrum of kidney disease - from preventive efforts to curb development of acute kidney injury or chronic kidney disease, to screening for kidney disease among persons at high risk, to access to subspecialty care and treatment of kidney failure with renal replacement therapy. World Kidney Day 2019 offers an opportunity to raise awareness of kidney disease and highlight disparities in its burden and current state of global capacity for prevention and management. In this editorial, we highlight these disparities and emphasize the role of public policies and organizational structures in addressing them. We outline opportunities to improve our understanding of disparities in kidney disease, the best ways for them to be addressed, and how to streamline efforts toward achieving kidney health equity across the globe.Для Организационного комитета Всемирного дня почки Заболевания почек - глобальная проблема общественного здравоохранения, затрагивающая более 750 млн человек во всем мире Распространенность заболеваний почек, а также их диагностика и лечение в разных странах существенно различаются. Значение и последствия заболеваний почек наиболее хорошо изучены в развитых странах, но в последнее время появляется все больше данных, свидетельствующих об аналогичной и даже более высокой распространенности заболеваний почек и в развивающихся странах. Во многих ситуациях частота заболеваний почек и обеспечение медицинской помощью определяются социально - экономическими, культурными и политическими факторами, что даже в развитых странах приводит к существенным различиям наносимого болезнью ущерба. Эти различия наблюдаются на разных этапах оказания помощи при заболеваниях болезнях почек: от профилактических мероприятий, направленных на предотвращение развития острого повреждения почек и хронической болезни почек, до скрининга на наличие болезни почек у лиц с высоким риском заболевания и доступа к специализированной медицинской помощи и проведению заместительной почечной терапии для лечения почечной недостаточности. Всемирный день почки - 2019 дает возможность повысить осведомленность о заболеваниях почек, а также осветить несоответствия между причиняемым ими ущербом и потенциальными возможностями их профилактики и лечения. В публикуемой передовой статье мы хотим заострить внимание на этих несоответствиях и подчеркиваем роль общественной политики и организационных структур в их устранении. Мы намечаем пути улучшения понимания этих различий, определяем основные подходы к достижению этого понимания, а также возможности оптимизации усилий для обеспечения равенства в вопросах поддержания здоровья почек во всем мире. Данная статья опубликована в журнале «Kidney International» и одновременно перепечатана в нескольких журналах. Эти публикации включают идентичные понятия и формулировки, но немного различаются по стилю и орфографии, мелким подробностям и объему рукописи в зависимости от стиля каждого журнала. Любая из этих версий может быть использована при цитировании данной статьи. Все авторы внесли равный вклад в концепцию, подготовку и редактирование рукописи. Авторы благодарят Рабочую группу по разработке Global Kidney Health Atlas, M. Lunney и M.A. Osman. Приложение Члены Организационного комитета Всемирного дня почки: Филипп Кам Тао Ли (Philip Kam Tao Li), Гильермо Гарсиа-Гарсиа (Guillermo Garcia-Garcia), Шэрон Андреоли (Sharon Andreoli), Дейдра Крю (Deidra Crews), Камьяр Калантар-Заде (Kamyar Kalantar-Zadeh), Чарльз Кернан (Charles Kernahan), Лата Кумарасвами (Latha Kumaraswami), Гамаль Саади (Gamal Saadi) и Луиза Страни (Luisa Strani). Перевод с английского Е.С. Камышовой и И.Н. Бобковой под редакцией Е.В. Захаровой. Перевод осуществлен по инициативе Российского диализного общества и одобрен Организационным комитетом Всемирного дня почки.

Living with chronic kidney disease (CKD) is associated with hardships for patients and their care partners. Empowering patients and their care partners, including family members or friends involved in their care, may help minimize the burden and consequences of CKD-related symptoms to enable life participation. There is a need to broaden the focus on living well with kidney disease and re-engagement in life, including an emphasis on patients being in control. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of ‘Living Well with Kidney Disease’ in an effort to increase education and awareness on the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to assess and address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care or to support labeling claims for medicines and devices. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care partners should feel supported to live well through concerted efforts by kidney care communities including during pandemics. In the overall wellness program for kidney disease patients, the need for prevention should be reiterated. Early detection with a prolonged course of wellness despite kidney disease, after effective secondary and tertiary prevention programs, should be promoted. WKD 2021 continues to call for increased awareness of the importance of preventive measures throughout populations, professionals and policymakers, applicable to both developed and developing countries.

Living with chronic kidney disease (CKD) is associated with hardships for patients and their care-partners. Empowering patients and their care-partners, including family members or friends involved in their care, may help minimize burden and consequences of CKD-related symptoms to enable life participation. There is a need to broaden the focus on living well with kidney disease and re-engagement in life, including emphasis on patients being in control. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of "Living Well with Kidney Disease" in an effort to increase education and awareness on the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to assess and address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care or to support labeling claims for medicines and devices. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care-partners should feel supported to live well through concerted efforts by kidney care communities including during pandemics. In the overall wellness program for kidney disease patients, the need for prevention should be reiterated. Early detection with prolonged course of wellness despite kidney disease, after effective secondary and tertiary prevention programs, should be promoted. WKD 2021 continues to call for increased awareness of the importance of preventive measures throughout populations, professionals, and policy makers, applicable to both developed and developing countries.Vivre avec l’insuffisance rénale chronique (IRC) représente un fardeau pour les patients et leurs partenaires soignants, dont leurs familles et amis. Une façon d’alléger ce fardeau et de réduire les conséquences des symptômes de l’IRC sur la participation à la vie serait de favoriser une plus grande autonomie des patients et de leurs partenaires soignants. Pour ce faire, l’accent mis sur le bien vivre avec la maladie et sur la participation à la vie doit être élargi en privilégiant notamment de mettre les patients en contrôle. Pour accroître l’éducation et la sensibilisation sur la responsabilisation des patients et, ultimement, encourager leur participation à la vie, le Comité directeur bipartite de la Journée Mondiale du Rein (JMR) a déclaré 2021 l’année du « bien vivre avec une maladie rénale ». Une stratégie qui nécessite l’élaboration et la mise en œuvre de mesures validées des résultats signalés par le patient afin d’aborder la participation à la vie dans les soins courants. Cette stratégie pourrait être appuyée par les organismes de réglementation comme mesure de qualité des soins ou pour appuyer les demandes relatives à l’étiquetage des médicaments et des dispositifs. Les organismes subventionnaires pourraient quant à eux établir des appels d’offres à objectifs de recherche définis afin de répondre aux priorités des patients. Les patients et leurs partenaires soignants devraient se sentir soutenus, même en contexte de pandémie, par des efforts concertés des communautés de soins en santé rénale. Dans le cadre du program de bien-être global destiné aux patients atteints d’une néphropathie, il convient de réitérer la prévention. À la suite de programs efficaces de prévention secondaire et tertiaire, il convient également de promouvoir une détection précoce avec une évolution prolongée du bien-être malgré une maladie rénale. La JMR 2021 continue d’appeler à une plus grande sensibilisation des populations, des professionnels et des décideurs quant à l’importance de mesures préventives applicables tant dans les pays développés que dans les pays en développement.

Living with chronic kidney disease (CKD) is associated with hardships for patients and their care-partners. Empowering patients and their care-partners, including family members or friends involved in their care, may help minimize the burden and consequences of CKD-related symptoms to enable life participation. There is a need to broaden the focus on living well with kidney disease and re-engagement in life, including an emphasis on patients being in control. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of "Living Well with Kidney Disease" in an effort to increase education and awareness on the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to assess and address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care or to support labeling claims for medicines and devices. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care-partners should feel supported to live well through concerted efforts by kidney care communities including during pandemics. In the overall wellness program for kidney disease patients, the need for prevention should be reiterated. Early detection with a prolonged course of wellness despite kidney disease, after effective secondary and tertiary prevention programs, should be promoted. WKD 2021 continues to call for increased awareness of the importance of preventive measures throughout populations, professionals, and policy makers, applicable to both developed and developing countries.

Author(s): Crews, Deidra C; Bello, Aminu K; Saadi, Gamal; World Kidney Day Steering Committee

Kidney disease is a global public health problem, affecting over 750 million persons worldwide. The burden of kidney disease varies substantially across the world, as does its detection and treatment. In many settings, rates of kidney disease and the provision of its care are defined by socio-economic, cultural, and political factors leading to significant disparities. World Kidney Day 2019 offers an opportunity to raise awareness of kidney disease and highlight disparities in its burden and current state of global capacity for prevention and management. Here, we highlight that many countries still lack access to basic diagnostics, a trained nephrology workforce, universal access to primary health care, and renal replacement therapies. We point to the need for strengthening basic infrastructure for kidney care services for early detection and management of acute kidney injury and chronic kidney disease across all countries and advocate for more pragmatic approaches to providing renal replacement therapies. Achieving universal health coverage worldwide by 2030 is one of the World Health Organization's Sustainable Development Goals. While universal health coverage may not include all elements of kidney care in all countries, understanding what is feasible and important for a country or region with a focus on reducing the burden and consequences of kidney disease would be an important step toward achieving kidney health equity.

Author(s): Piccoli, Giorgina B; Alrukhaimi, Mona; Liu, Zhi-Hong; Zakharova, Elena; Levin, Adeera; World Kidney Day Steering Committee