Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.
Nat Rev Nephrol. 2021 Jan;17(1):15-32. doi: 10.1038/s41581-020-00363-6. Epub 2020 Nov 13.
Globally, more than 5 million people die annually from lack of access to critical treatments for kidney disease - by 2040, chronic kidney disease is projected to be the fifth leading cause of death worldwide. Kidney diseases are particularly challenging to tackle because they are pathologically diverse and are often asymptomatic. As such, kidney disease is often diagnosed late, and the global burden of kidney disease continues to be underappreciated. When kidney disease is not detected and treated early, patient care requires specialized resources that drive up cost, place many people at risk of catastrophic health expenditure and pose high opportunity costs for health systems. Prevention of kidney disease is highly cost-effective but requires a multisectoral holistic approach. Each Sustainable Development Goal (SDG) has the potential to impact kidney disease risk or improve early diagnosis and treatment, and thus reduce the need for high-cost care. All countries have agreed to strive to achieve the SDGs, but progress is disjointed and uneven among and within countries. The six SDG Transformations framework can be used to examine SDGs with relevance to kidney health that require attention and reveal inter-linkages among the SDGs that should accelerate progress.
全球每年有超过 500 万人因无法获得治疗肾病的关键治疗而死亡——到 2040 年,慢性肾病预计将成为全球第五大死亡原因。肾脏疾病尤其难以解决,因为它们在病理上多种多样,而且往往没有症状。因此,肾脏疾病常常被诊断得很晚,全球肾脏疾病的负担仍然被低估。如果不能及早发现和治疗肾脏疾病,患者的护理就需要专门的资源,这会增加成本,使许多人面临灾难性的健康支出风险,并对卫生系统造成高机会成本。预防肾脏疾病具有很高的成本效益,但需要采取多部门整体方法。每个可持续发展目标 (SDG) 都有可能影响肾脏疾病的风险,或改善早期诊断和治疗,从而减少对高成本护理的需求。所有国家都同意努力实现可持续发展目标,但进展在各国之间和各国内部是脱节和不平衡的。可持续发展目标转型框架可用于审查与肾脏健康相关的需要关注的可持续发展目标,并揭示可持续发展目标之间的相互联系,这些联系应加速进展。