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![Page 1: The European Kidney Health Alliance Role of EKHA in creating interest for research in kidney diseases in Europe. Prof Norbert Lameire, Chairman EKHA University.](https://reader035.fdocuments.in/reader035/viewer/2022081512/56649e2d5503460f94b1c579/html5/thumbnails/1.jpg)
The European Kidney Health Alliance
Role of EKHA in creating interest for research in
kidney diseases in Europe.Prof Norbert Lameire, Chairman EKHA
University Hospital, Gent
Belgium
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What are the major problems in chronic kidney diseases in Europe? .
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Nr. of patients on Renal Replacement TherapyNr. of patients on Renal Replacement Therapy
284,000
1995 2000 2005 2010 2015
360,000
435,000
503,000~565,000
ERA-EDTA Registry
EKH
A: W
orld
Kid
ney
Day
Direct medical costs: ~21 billion Euro/yr
Calculated for the EU-27 countries
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40,9
19,9
36,9
18,8
23,9
12,4
15,3
7,212,1
5,6
0
5
10
15
20
25
30
35
40
45
30 35 40 45 50 55 60 65 70 75 80
Age (years)
Normal kidney function
60 - 45%
45 - 30%
30 - 15%
<15% or RRT
Life
exp
ecta
ncy
(in
year
s)
Chronic Kidney Disease and life expectancyChronic Kidney Disease and life expectancy
Gansevoort et al,Lancet (in press)
Alberta Kidney Disease Network dataN=949,119. Courtesy: Brenda Hemmelgarn
EKH
A: W
orld
Kid
ney
Day
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27,5 32,9 41,1 48,858,0
34,6 28,125,9
24,4 7,5
37,9 39,0 33,0 26,8 34,5
0%10%20%30%40%50%60%70%80%90%
100%
Normal 60 - 45% 45 - 30% 30 - 15% <15% or RRT
Kidney function
OthersCancerCardiovascular
Causes of death in CKDCauses of death in CKDEK
HA:
Wor
ld K
idne
y D
ay
Gansevoort et al,Lancet (in press)
Alberta Kidney Disease Network dataAdjusted for age and genderN=949,119. Courtesy: Brenda Hemmelgarn
Kidney function
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Health care costs for different chronic diseases in Spain
Arrieta et al, Nefrologia 2011;31(5):505-513
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Health care costs for different chronic diseases in Spain
Arrieta et al, Nefrologia 2011;31(5):505-513
47525 0.05% 1-2%UK
UK data Sharif, Baboolal, PDI,2011; 31(S2):S58–S62
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How to prevent progression of CKD?How to prevent progression of CKD?
Kidney function
0%
10%
Follow-up (years)
0 1 2 3 4 5 6 7 8 9 10
Late intervention
Early intervention
Start dialysis
60%
EKH
A: W
orld
Kid
ney
Day
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Interventions to improve prognosis?Interventions to improve prognosis?EK
HA:
Wor
ld K
idne
y D
ay
Can progression of CKD be prevented?
Strict blood pressure controlLowering of urinary protein loss (RAASi)
Strict diabetes regulationStop smokingFight obesity
Use healthy food
Can cardiovascular disease in CKD be prevented?
medication diet
Strict blood pressure controlStrict diabetes regulation
Lowering cholesterolStop smokingFight obesity
Use healthy fooddiet
medication
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Good news for “alcoholics” in the audience :
Alcohol prevention of (type 2) diabetes
moderate consumption of alcohol –less de novo diabetes vs tee-totaler :
nurses health study
Hoorn studyHu,New Engl J Med (2001) 345: 790
de Vegt, Diab Res Clin Pract (2002) 57: 53
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Food and CKDFood and CKDEK
HA:
Wor
ld K
idne
y D
ay
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Patient awareness of early CKD is lowPatient awareness of early CKD is lowEK
HA:
Wor
ld K
idne
y D
ay
More than 30% function
Less than 30% function
Less than 10% function
no symptoms
life threatening
symptoms
Fatigue
Itching
Nausea
Loss of appetite
Weight loss
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Kidney transplantation: facts and rationale
In the EU: 250 000 patients on dialysis
60 000 on renal transplant WL
18 000 transplants/y
• In the EU: 250 000 patients on dialysis
• 60 000 on renal transplant WL
• 18 000 transplants/y
• Costs:
• Hemodialysis: 40 K€ /y
• Peritoneal dialysis: 15-25 K€ /y
• Transplantation (LD/DD):
• 1st y: 50 K€ /y
• beyond 2nd y: 12 K€ /y
HD
GP
Kidney transplantation improves both the quality and QoL Is cost-effective
No tt
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Dynamics of the Eurotransplant kidney transplant waiting list between 1969-2012
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EU Action Plan on Organ Donation and Transplantation (2009-2015) –The ACTOR study
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Who are we? Alliance of non-profit organisations representing the key stakeholders
in kidney health in EuropeFull members
Associate members
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What do we aim to achieve?
Raise awareness of the importance of kidney health and the growing
prevalence and societal burden of CKD
Influence strategies for early detection and prevention
Promote harmonized standards of care throughout Europe
Influence future EU research priorities and secure funding for innovation
in care
Cooperate with other key stakeholders in the chronic disease arena
Facilitate exchange of information and provide expertise to the EU
policy makers
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What this means to EDTNA/ERCA
• Create opportunities for nephrology community to engage in the EU public health debate
• Position the importance of kidney health in chronic disease prevention
• Strengthen EKHA’s reputation as a key partner in EU Health policy making
• Increase the recognition of the burden of CKD and advocate for: A European Strategy on Chronic Disease which includes CKD National plans to improve kidney health Policies for prevention (primary & secondary), Policies for screening /early diagnosis Increased funding for research
Amplify nephrology’s voice in the health policy debate
EKHA members are seen as the driver for kidney health in Europe
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at level European Commission
Lobbying activities
at level European Parliament
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Meetings with the European Commission
DG Sanco (Health for Growth)Objectives of the meeting: EKHA met in June with officials from DG Sanco to promote the inclusion of kidney disease in Calls for Proposals under Health for Growth (3rd Public Health Programme of the EU). Specific objectives were: To enquire about the latest state of play regarding the decision on the programme and to
understand any major differences compared to the previous programme To find out whether the Commission has already begun to prepare the Work Plan for 2014 and
what the topics for calls could be To position CKD as major chronic disease, by making the correlation with CVD and diabetes, and
suggest consideration of CKD as priority area for public health research under the Annual Work Plan in 2014 or next years
Outcomes: EKHA has been invited to propose topics addressing kidney disease for consideration under
upcoming calls for proposals
Research topics have been prepared by EKHA members and submitted to the responsible officials in DG Sanco.
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1. Production of European guidance for advancement of patient care and the sharing of best practice:
a) Management of diabetes in patients with chronic kidney disease (CKD)
b) Management of chronic kidney disease in the elderlyc) Management of renal orphan diseases 2. Guidelines for dialysis care based on a combination of Registry data and a cull of other best-practice programmes across Europe (EU DOPSS)
Public health research topics proposed by EKHA for Annual Work Plan 2014
Health for Growth Programme
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Chaired by Ms Zofija Mazej Kukovič (Slovenia)
Objectives of the MEP Group
• Act as a hub for the exchange of experience, information and data on kidney health
• Drive the development & implementation of targeted EU policies
• Address specific EU and national policies which have an impact on the lives of kidney patients and their carers
Enlisting the support of policy makers
MEP Group for Kidney Health
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Pilot Project ProposalTitle: The Effect of Differing CKD Treatment Modalities andTransplantation Practices on Health Expenditure and Patient Outcome
Objectives: to compare, from a macro-economic perspective, the various treatment modalities
for CKD in European Member States, by investigating the factors that influence the treatment choice (by patient or doctor), and the impact of the choice on healthcare budgets.
to answer the question “Why is there such an enormous variability in practice in the overall management of CKD in Europe and how could these practices be harmonised in order to ensure equal and better quality of care while reducing costs?”
Expected outcomes: help harmonising treatments for end stage kidney disease improve the availability of transplantation across Member states
Vote in the European Parliament scheduled in September. If successful, the Commission will implement the pilot project through a call for proposals in Spring 2014. Requested budget – 2 mil. Euro for 2 years
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MEP Twinning ProgrammeEngaging MEPs in EKHA goals via national activity
Goal: Improve the national dissemination of European progress in kidney health promotion - strengthen the link between European and national health policy and to leverage the influence of European policy and guidance locally
How: Twinning Programme would essentially consist of a connection between an MEP and the national nephrology society, and/or the national kidney foundation in his or her country.
Why should MEPs be interested: A way for MEPs to make a connection to their national health landscape - connecting with national stakeholders will help to make a difference locally (*interesting given elections next year year). For national societies, EKHA’s programme gives them direct link to EU policy
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European Chronic Disease AllianceWorking in Partnership to Call foran EU Strategy on Chronic Disease
European Parliament Resolution on NCDs
Stakeholder Consultation on NCDs in the EU
EU Council Conclusions on Chronic Diseases
Joint Action at National level on Chronic
Diseases
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ECDA
EKHA
ERA-EDTAEDTNA/ERCA
NATIONAL SOCIETIES
The Strength of a United Voice
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“Healthy citizens are the greatest asset
any country can have.”
—Sir Winston Churchill
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Thank you!