CKD is a serious, progressive disease defined by declining kidney function which, across all grades of severity, affects approximately 700 million people worldwide. While there are medications that can address some of the risk factors for CKD, no cure currently exists, and few current therapies work directly to slow renal disease progression.

With earlier diagnosis and intervention, it is possible to slow or stop the progression of CKD, yet diagnosis often comes too late – about 90% of those with CKD don’t know they have it because, in the milder stages of the disease, it is usually asymptomatic.
CKD often occurs in the context of other comorbidities. People with diabetes, for example, are twice as likely to develop CKD than those without, and more than 40% of people with heart failure also have CKD. Sadly, people with CKD are more likely to die from a cardiovascular event than to progress to end-stage kidney disease (ESKD).

As kidney function declines, patients face an increased risk of developing further complications. Hyperkalaemia (elevated levels of potassium in the blood) and anaemia are both common complications of CKD, associated with poorer cardiovascular outcomes and an increased risk of hospitalisation and death. They also present significant lifestyle burdens, with people at risk of hyperkalaemia often asked to adopt a strict low-potassium diet and anaemia frequently causing fatigue, cognitive impairment and reduced quality of life.

CKD often has a profound impact on someone’s personal life, with social, economic and physical effects. In speaking with those living with CKD, I have heard first-hand about the toll the disease can take on daily life. Some are sad that they can no longer eat the food they love; others wish they had more energy and time to spend time with grandkids. Many people are simply scared for the future.

Early findings from the CKD Patient Impact Index, recently presented at ASN Kidney Week 2020, offer new insights into the specific daily challenges of people living with CKD. Finances and job loss, time lost to appointments and dialysis, mental health implications, sleep schedules, planning of life events and dietary changes were all identified as high impact burdens.

Taking time to hear the concerns and challenges of people living with CKD can help us understand the full burden of the disease and develop tangible and realistic solutions to improve both clinical outcomes and quality of life.

There is a very real and unmet need to improve the standard of care for people with CKD. At AstraZeneca, we are working to advance solutions across the full continuum of renal care, from prevention and protection before a CKD diagnosis, to help slowing disease progression and addressing complications across all stages of the disease.

As we continue to follow the science to understand the underlying mechanisms of associated cardiovascular, renal and metabolic diseases, we are working to address shared risk factors and develop solutions designed to address multiple concomitant diseases. We are also considering how to make treatment interventions more tolerable and less burdensome. For instance, we are exploring patient preferences for hyperkalaemia therapies, including taste and texture of medications, to capture insights into factors likely to increase adherence to treatment.

Of course, helping someone manage a chronic disease is about more than providing new treatment options. In order to truly drive meaningful change in the management of CKD, we need to identify the barriers to early diagnosis and treatment adherence, ensure CKD tests are integrated into standard medical check-ups, and empower patients and doctors to have meaningful conversations.

A holistic approach to disease management requires collaboration: CKD is a challenge that can’t be solved alone. As an industry, we are seeing the great progress that can be made when healthcare innovators come together. At AstraZeneca, we prioritise partnerships that leverage the power of data science and digital technologies to enhance the delivery of treatment, reduce inefficiencies throughout the patient journey and support people to engage with their own health. We are proud to be currently partnering with several digital health companies that are focused on exploring new ways to diagnose and manage renal disease.

We need to continue investing in innovative solutions that empower people living with CKD and healthcare professionals alike, along with real-world evidence that allows us to better understand current treatment patterns and the full impact of the disease. By raising awareness of the burden of CKD and its complications, expanding early detection and prioritising early intervention, we can work towards transforming renal care and help people live longer, healthier lives.

Joris Silon is Senior Vice President, Global Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals Business Unit at AstraZeneca