Chronic Kidney Disease (CKD) Primary and Secondary Prevention

Primary prevention aims to avert emergence of de novo chronic kidney disease (CKD) in at-risk populations. Prevention strategies encompass: (1) Risk Factor Management including control of Diabetes, management of Hypertension, adopting a healthy lifestyle, engaging in physical activity and avoiding risk factors such as tobacco and alcohol use; (2) Engaging in regular screening of kidney function tests for individuals at high risk, and (3) Public Awareness and Education on kidney health, risk factors, and the importance of early intervention.

Secondary prevention aims to identify CKD as early as possible and tertiary prevention strives to either avoid end-stage kidney disease, also known as kidney failure or slow the progression of CKD in individuals already diagnosed by preventing  acute kidney injury (AKI) and monitoring the at-risk populations’ estimated glomerular filtration rate (eGFR). Strategies include: (1) Regular monitoring and follow up; (2) Preventing progression using reno-protective medications and avoiding or adjusting medications that may worsen kidney disease; (3) Nutritional interventions through tailored diets, nutrient and mineral control and substitution; (4) Lifestyle modification; (5) Management of comorbidities such as heart disease, anaemia, and bone mineral disorders commonly associated with CKD and (6) Patient Education.

Implementing these strategies can significantly impact the quality of life and clinical outcomes for individuals at risk for or living with CKD.

Dr Thandiwe Dlamini is a Specialist Physician and Nephrologist based at the Mbabane Government Hospital in Eswatini. Her interests include acute kidney injury, peritoneal dialysis, hypertension, and teaching. She has taught students enrolled in the postgraduate diploma in Nephrology Nursing, at the University of Eswatini from 2018 to 2021, as a part time lecturer. She has presented at training workshops for doctors, on the early detection and management of kidney disease, and has contributed to the standard treatment guidelines for kidney disease and hypertension in Eswatini, under the Ministry of Health.

Objectives:

1. To build capacity of doctors for early detection and prevention of chronic kidney disease.
2. To enable doctors to use evidence-based rationale for decision making in patients with Acute Kidney Injury and Chronic Kidney Disease.
3. Equip doctors with an in-depth knowledge of comorbid conditions that contribute to or may worsen kidney disease and provide an understanding on how to compliment patient care and service delivery.

Date: Friday, 11th of October 2024

Time: 15.00 SAST