nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.36485/1561-6274-2020-24-2-9-21nefr-1798Research ArticleПЕРЕДОВАЯ СТАТЬЯLEADING ARTICLEЗдоровые почки всем и везде: от профилактики и выявления до равного доступа к медицинской помощиKidney health for everyone everywhere from prevention to detection and equitable access to careЛиФилипп КамТаоKam-Tao LiPhilip

Кафедра медицины и терапии, Исследовательский центр имени Кэрол и Ричарда Ю, Больница принца Уэльского

Гонконг

Department of Medicine and Therapeutics, Carol & Richard Yu PD Research Centre, Prince of Wales Hospital

30–32 Ngan Shing Street, Shatin, New Territories, Hong Kong

philipli@cuhk.edu.hkГарсия-ГарсияГильермоGarcia-GarciaGuillermo

отделение нефрологии, Гвадалахарский гражданский госпиталь имени Фрая Антонио Алькальде

Гвадалахара, штат Халиско

Nephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde

Guadalajara, Jal.

ЛуиСиу-ФайLuiSiu-Fai

Отдел организации управления здравоохранением, Школа общественного здравоохранения и первичной медико-санитарной помощи «Жокей-клуб»

Гонконг

Division of Health System, Policy and Management, Jockey Club School of Public Health and Primary Care

Hong Kong

АндреолиШэронAndreoliSharon

Больница имени Джейма Уиткомба Райли для детей

Инианополис

James Whitcomb Riley Hospital for Children

Indianapolis

ФунгУинстон Винг-ШингFungWinston Wing-Shing

Кафедра медицины и терапии, Исследовательский центр имени Кэрол и Ричарда Ю, Больница принца Уэльского

Гонконг

Department of Medicine and Therapeutics, Carol & Richard Yu PD Research Centre, Prince of Wales Hospital

Hong Kong

ГрадскиАннаHradskyAnne

улица Искусств 1-2, 6 этаж, B-1210, Брюссель

Avenue des Arts 1-2, 6th floor, B-1210, Brussels

КумарасвамиЛатхаKumaraswamiLatha

Ченнаи

Chennai

ЛиакопулосВасилиосLiakopoulosVassilios

отдел нефрологии и артериальной гипертензии, 1-я кафедра терапии и внутренних болезней, госпиталь Aмериканской эллинской образовательной ассоциации

Салоники

Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital

Thessaloniki

РахимоваЗиёдаRakhimovaZiyoda

улица Искусств 1-2, 6 этаж, B-1210, Брюссель

Avenue des Arts 1-2, 6th floor, B-1210, Brussels

СаадиГамальSaadiGamal

отдел внутренних болезней, медицинский факультет

Гиза

Nephrology Unit, Department of Internal Medicine, Faculty of Medicine

Giza

СтраниЛуизаStraniLuisa

улица Искусств 1-2, 6 этаж, B-1210, Брюссель

Avenue des Arts 1-2, 6th floor, B-1210, Brussels

УласиИфеомаUlasiIfeoma

отделение нефрологии, медицинский факультет, Медицинский колледж

Итуку-Озалла, Энугу

Renal Unit, Department of Medicine, College of Medicine

Ituku-Ozalla, Enugu

Калантар-ЗадеКамьярKalantar-ZadehKamyar

отдел нефрологии, артериальной гипертензии и трансплантации почки

Ориндж, Калифорния

Division of Nephrology and Hypertension and Kidney Transplantation

Orange, California. Tel: (714) 456-514,2 Fax: (714) 456-6034

kkz@uci.eduКитайский университет ГонконгаКитайChinese University of Hong KongChinaНаучный центр здоровья Университета ГвадалахарыМексикаUniversity of Guadalajara Health Sciences CenterMexicoКитайский университет ГонконгаКитайThe Chinese University of Hong KongChinaМедицинская школа Университета ИндианыСоединённые Штаты АмерикиIndiana University School Of MedicineUnited StatesГоловной офис инициативы «Всемирный день почки»БельгияWorld Kidney Day OfficeBelgiumФонд ТанкерИндияTanker FoundationIndiaУниверситет имени Аристотеля в СалоникахГрецияAristotle University of ThessalonikiGreeceКаирский университетЕгипетCairo UniversityEgyptУниверситет НигерииНигерияUniversity of NigeriaNigeriaМедицинская школа г. Ирвайн; Калифорнийский университетСоединённые Штаты АмерикиUniversity of California Irvine School of MedicineUnited States202007022020242921Copyright © Ли Ф., Гарсия-Гарсия Г., Луи С., Андреоли Ш., Фунг У., Градски А., Кумарасвами Л., Лиакопулос В., Рахимова З., Саади Г., Страни Л., Уласи И., Калантар-Заде К., 20202020Ли Ф., Гарсия-Гарсия Г., Луи С., Андреоли Ш., Фунг У., Градски А., Кумарасвами Л., Лиакопулос В., Рахимова З., Саади Г., Страни Л., Уласи И., Калантар-Заде К.Kam-Tao Li P., Garcia-Garcia G., Lui S., Andreoli S., Fung W., Hradsky A., Kumaraswami L., Liakopoulos V., Rakhimova Z., Saadi G., Strani L., Ulasi I., Kalantar-Zadeh K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/1798

Глобальное бремя хронической болезни почек (ХБП) стремительно увеличивается; так, согласно прогнозам, к 2040 г. ХБП окажется на пятом месте среди наиболее частых причин сокращения продолжительности жизни во всем мире. Более того, ХБП является основной причиной катастрофических расходов на здравоохранение. В странах с высоким уровнем дохода расходы на диализ и трансплантацию составляют до 3 % от ежегодного бюджета здравоохранения. В связи с этим особенно важно, что развитие и прогрессирование ХБП во многих случаях можно предотвратить. В 2020 году кампания «Всемирный День Почки» посвящена в первую очередь мероприятиям по первичной, вторичной и третичной профилактике ХБП. В данной статье представлены описание и анализ мер, которые могут быть внедрены в каждой стране с целью пропаганды и дальнейшего развития профилактики ХБП. Первичная профилактика заболеваний почек должна быть направлена на модификацию факторов риска и устранение структурных повреждений почек и мочевыводящих путей, а также ограничение воздействия факторов риска окружающей среды и нефротоксических веществ. У лиц, уже страдающих заболеваниями почек, вторичная профилактика (включая оптимизацию артериального давления и контроль гликемии) должна быть основной целью как обучения, так и клинических вмешательств. У пациентов с далеко зашедшими стадиями ХБП настоятельно рекомендуются превентивные меры, позволяющие предотвратить или отсрочить потребность в диализе или трансплантации почки, а именно – лечение уремии и сопутствующих состояний, таких как сердечно-сосудистые заболевания. Для реализации профилактического подхода необходимо принятие мер на государственном уровне. Несмотря на то, что в той или иной стране может существовать национальная политика и стратегия по профилактике неинфекционных заболеваний в целом, конкретные меры, направленные на повышение осведомленности и настороженности в отношении диагностики, ведения и лечения ХБП, часто отсутствуют. В связи с этим необходимо повышение информированности населения, медицинских работников и политиков о важной роли профилактических мероприятий.

The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual healthcare budget in high-income countries. Crucially, however, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions – be it primary, secondary or tertiary. This complementing article focuses on outlining and analyzing measures that can beimplemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, management of co-morbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to proliferate the preventive approach. While national policies and strategies for non-communicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management and treatment are often lacking. Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals and policy makers.

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The authors declare that there are no conflicts of interest present.