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World Kidney Day 2009: Chronic Kidney Disease and

Hypertension: Two Sides of the Same Coin

Patients with CKD should be informed and instructed about

hypertension and taught self-measurement techniques

Eberhand Ritz and George Bakris

Raising Awareness

On behalf of the World Kidney Day Organising Committee

World Kidney Day (WKD) will take place on the 12th of March
2009. The campaign is focusing on the importance of hypertension. Chronic kidney disease (CKD) is both a culprit and a
victim of hypertension (Klahr 1989). On one hand, reduced
kidney function is a major cause of hypertension; on the other
hand, hypertension is a major factor initiating and promoting
progressive loss of renal function.
World Kidney Disease aims both to improve population awareness of hypertension and to foster more aggressive intervention by physicians to reach blood pressure goals. Adequate
lowering of blood pressure to the current guideline goal is
arguably the single most neglected aspect in the management
of CKD. This fact prompted the International Society
Nephrology (ISN) and the International Federation of Kidney
Foundations (IFKF) to devote this years WKD to the topic of
hypertension.

Why is Hypertension In CKD Relevant?

The high and growing prevalence of early-stage CKD as a
contributor to higher cardiovascular risk has only been appreciated in the past decade. The increasing frequency of CKD
and end-stage kidney disease worldwide is alarming: in
2004, 1.9 million patients were on renal replacement therapy worldwide; by 2010, this figure is projected to increase by
40% (Alebiosu & Ayodele 2005; Atkins 2005; Coresh et al.
2007). The most common causes of CKD are hypertension
and diabetes.

One important barrier to overcome to ensure greater awareness is to increase focused education of physicians as well as
patients. Projects such as the Kidney Early Evaluation Program
(KEEP; Rao et al. 2008) programme and the ISN COMGAN
(Commission for the Global Advancement of Nephrology)
Research and Prevention Programme are exemplary and need
to be further elaborated around the world.
This year, WKD will focus on:
Raising public awareness of the importance and magnitude
of the hypertension problem in CKD.
Increasing awareness in the medical community concerning
- the prevalence of CKD
- the role of blood pressure
- the management of target blood pressure values
Ensuring that CKD patients and patient organizations are
aware of the crucial importance of self-measurement and
treatment of elevated blood pressure to target values.

Partners
World Kidney Day is collaborating with the International
Society of Hypertension through the World Hypertension
League, World Hypertension Day (17 May 2009) and World
Salt Awareness Week (17 February 2009) initiated by the
World Action on Salt and Hypertension (WASH). Uniting
behind the slogan keep the pressure down, WKD and its partners will put particular emphasis on lifestyle modification as
the cornerstone of therapy, supplemented by antihypertensive
therapy, to break the unholy alliance between blood pressure
and CKD. This emphasis of lifestyle change, for example,
reduced sodium intake and weight loss, will focus particularly
on patients with early CKD.

What are the Goals of World Kidney Day?

World Kidney Day is focusing on the issue of hypertension in
CKD to achieve the following goals:
Proper measurement of blood pressure and examination of
urine to become part of routine medical examinations
Obligatory screening of high-risk patients (metabolic syndrome, diabetes, cardiovascular patients and family history
of CKD)

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Journal of Renal Care 2009

On the Move for Kidney Health

The WKD organizers are calling on the EDTNA/ERCA and the
entire kidney community to play a role in this years campaign.
Please participate in your local community by organizing
awareness raising events and activities. Materials and event
ideas are available for all members of the kidney community to
download and use at: http://www.worldkidneyday.org.

2009 European Dialysis and Transplant Nurses Association/European Renal Care Association

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References
Alebiosu C.O. & Ayodele O.E. (2005). The global burden of chronic kidney disease and the way forward. Ethnicity and Disease 15(3),
418-423.
Atkins R.C. (2005). The epidemiology of chronic kidney disease. Kidney
International Supplement 2005, S14-S18.
Coresh J., Selvin E., Stevens L.A. et al. (2007). Prevalence of chronic

kidney disease in the United States. Journal of the American

Medical Association 298(17), 2038-2047.
Klahr S. (1989). The kidney in hypertensionvillain and victim. New
England Journal of Medicine 320(11), 731-733.
Rao M.V., Qiu Y., Wang C. & Bakris G. (2008). Hypertension and CKD:
Kidney Early Evaluation Program (KEEP) and National Health and
Nutrition Examination Survey (NHANES), 1999-2004. American
Journal of Kidney Disease 51(4 Suppl 2), S30-S37.

2009 European Dialysis and Transplant Nurses Association/European Renal Care Association

Journal of Renal Care 2009

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