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End to Deaths from Acute Kidney Injury?

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Preventable deaths caused by acute kidney injury (AKI) could be nearly eliminated in just 10 years, according to leading medical experts, in an article published in The Lancet. This often forgottencondition – which affects around 13 million people every year and contributes to 1.7 million deaths annually – is preventable and can be treated for as little as $US150 per patient.

A major new Commission from The Lancet and the International Society of Nephrology (ISN)
reports on an ISN initiative, launched in 2013, which calls for preventable deaths from AKI to be eliminated by 2025. According to Professor Giuseppe Remuzzi, President of the ISN, and one of the Commission authors, “The ability to provide lifesaving treatments for acute kidney injury provides a compelling argument to consider therapy for it as much as a basic right as it is to give antiretroviral drugs to treat HIV, especially as care needs only be given for a short period of time in most patients.”

AKI, which causes an abrupt or rapid decline in kidney function, is a serious and increasingly common condition worldwide. In high-income countries,AKI often arises after major surgery and use of medicines which affect kidney function in hospitals, whereas in low- and middle-income countries (LMICs) it is mainly a community acquired disease that affects young and previously healthy individuals, and is often associated with diarrhoea, infections such as malaria, and toxins.

Complications include chronic kidney disease and end-stage renal disease that need dialysis and transplantation, resulting in high long-term costs. NICE estimates the yearly cost of AKI to the NHS in England to be between £434 million and £620 million per year, which is higher than the costs associated with breast cancer, or lung and skin cancer combined.

New estimates produced for the Commission suggest that 1 in 5 adults admitted to hospital
worldwide develop AKI. But because most cases in LMICs are not recorded, this is likely to be only the tip of the iceberg in terms of the true public health burden of AKI in these regions, say the authors.

Visit www.thelancet.com and www.nice.org.uk for more information.