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The Potential Impact of Public Health Interventions in Preventing Kidney Disease

机译：公共卫生干预措施对预防肾病的潜在影响

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摘要

The years of life lost and years lived with disability resulting from chronic kidney disease (CKD) increased globally by 90% and 49.5%, respectively, between 1990 and 2013. In addition to the traditional factors, infections, low birthweight, environmental factors, and low socioeconomic status contribute to the CKD burden in low- and middle-income countries. System-level challenges such as poor appreciation of the burden, insufficient human resources, high health care costs, poor referral pathways, unreliable health information systems, and inadequate medicine supply pose barriers to CKD control. In this article, we present evidence that the CKD burden in low- and middle-income countries is related to system-wide issues, which could be reduced effectively using innovative, affordable, and scalable interventions. A multipronged approach is required including improving socioeconomic determinants of health, enabling the environment for healthy decision making, and sustainable interventions. Innovative approaches include promoting healthy behaviors, counseling, and education in primary care, task-sharing between physicians and nonphysicians, using technology to train nonphysicians to screen, diagnose, refer, follow-up, and educate patients, and ensuring quality. Stronger political will and system-level change are needed to prevent and manage CKD if the sustainable development goals of reducing premature mortality from noncommunicable diseases by 2030 are to be attained.
机译：在1990年至2013年间，慢性肾脏疾病（CKD）患有慢性肾脏疾病（CKD）的残疾损失和多年的生命损失和多年的生活损失了90％和49.5％。除了传统因素，感染，低出生体重，环境因素和低社会经济地位有助于低收入和中等收入国家的CKD负担。系统级挑战，如对负担，人力资源不足，高医疗费用，转诊途径差，不可靠的健康信息系统以及不适当的药物供应对CKD控制的障碍等挑战。在本文中，我们提出了证据表明，低收入和中等收入国家的CKD负担与系统范围内的问题有关，可以使用创新，经济实惠和可扩展的干预措施有效地减少。需要一种多强制方法，包括改善健康的社会经济决定因素，从而实现健康决策的环境和可持续的干预措施。创新方法包括促进初级保健，医师和非心理学家的初级保健，任务分享的健康行为，咨询和教育，使用技术培训非物理学来筛选，诊断，参考和教育和教育患者，并确保质量。如果要实现降低2030年的非传染性疾病的可持续发展目标，则需要更强大的政治意愿和系统级变更，以防止和管理CKD。

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