New clinical support for ‘silent but deadly’ disease

Chronic kidney disease (CKD) is twice as common as diabetes, but less than 10% of the one in 10 adults with signs of probable CKD are aware they may have the condition.
 
The disease, which on average kills 63 Australians each day, has also recently been labelled a ‘national emergency’ by Kidney Health Australia (KHA) due to its disproportionate and devastating impact on Aboriginal and Torres Strait Islander people.
 
But despite its widespread presence in Australia, there are ongoing concerns that CKD remains under-recognised and under-treated, especially as patients may lose up to 90% of kidney function before symptoms are present.
 
To help improve outcomes, NPS MedicineWise – which calls CKD a ‘silent but deadly’ disease – has established a new educational program focused on the early detection and management of the disease.
 
NPS MedicineWise medical advisor and GP Dr Caroline West says detecting CKD early is important, as timely management can slow disease progression and reduce the associated risk of cardiovascular disease. 
 
‘We can see how important it is to take the condition seriously, even if the early symptoms are minimal,’ she said.
 
‘There is without doubt an opportunity in the early stages of CKD to make lifestyle changes and to get started on the right medicines. Setting patients on the right course early may help slow the progression of the disease and reduce risk of a cardiovascular event.
 
‘Educate your patients as much as you can about the condition as it will help them to take an active role in management decisions and to advocate for themselves or someone they are caring for with CKD.’
 
The program was developed in collaboration with KHA and the National Aboriginal Community Controlled Health Organisation (NACCHO).
 
According to KHA, Aboriginal and Torres Strait Islander people are twice as likely to develop CKD and nearly four times more likely to die with the disease.
 
To help bridge this gap, a set of guidelines – Recommendations for culturally safe kidney care in First Nations Australians – has also recently been released.
 
KHA CEO Chris Forbes says they aim to ‘transform’ how kidney disease is diagnosed and managed within Indigenous communities.
 
‘Changes need to occur within the health sector to increase earlier detection of kidney disease within these communities and also ensure equitable and culturally appropriate care,’ he said.
 
‘[These guidelines] are underpinned by community voice and [are] outcome-focused, providing tangible and meaningful recommendations to implement across multiple levels of the health system.’
 
Ngarrindjeri and Yorta Yorta woman, Nari Sinclair, lives with kidney disease and helped develop the guidelines. She believes it is ‘about time people listened’.
 
‘We want action,’ Ms Sinclair said.
 
‘The guidelines are important because they show health services and specialists are listening and coming on our journey. Our families are important along this kidney journey, we need to include them too.’
 
GPs can screen patients at higher risk via the three-step Kidney Health Check, while NPS MedicineWise is also visiting practices across Australia to encourage GPs to start talking more to high-risk patients about their kidney heath.
 
The program draws recommendations from evidence-based guidance in the KHA CKD Management in primary care 4th edition handbook, while NPS MedicineWise has also published a two-part article that provides additional insight from four experts in the field.
 
Part one is centred on integrating targeted screening, early detection and diagnosis of CKD into patient care, and part two focuses on medicines for CKD, presented as a case study.
 
A webinar on a ‘multidisciplinary team approach to reducing risk’ by individualising medicine management has also been released.
 
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Aboriginal and chronic kidney disease CKD' health Islander Strait Torres