Editorial volume 18, n°2 Mars 2025
Correspondence author
Abdou Niang, MD, PhD
Courriel : abdounian@gmail.com
The big question we health professionals or not, must ask ourselves is: Are our kidneys functioning normally? Why do we have to ask ourselves this question regularly? Why do we almost never ask ourselves this question?
For the first question, it’s because kidney disease is a great « silent killer ». It shows almost no signs at the beginning of the disease. By the time the disease is diagnosed by its clinical manifestations, it is already at an advanced state. So, the key lies in prevention and early diagnosis. Fortunately, we now have the means to do so, but the most difficult thing is to implement them. We are going to come back to these means of prevention and the tools that allow us to make an early diagnosis today.
Why do we have to ask ourselves this question regularly?
On a world scale the total number of individuals with chronic kidney disease (CKD), acute kidney injury (AKI), and those on Kidney replacement therapy (KRT) exceeds 850 million, a truly concerning figure that is twice the estimated number of people with diabetes worldwide and >20 times higher than the number of individuals affected by AIDS/ HIV worldwide. Thus, kidney diseases are one of the most common diseases worldwide (1). In 2016, this disease was 13th on the list of causes of death on a world scale, and in 2040, it is expected to be the 5th leading cause of years of life lost (2-3).
This situation is particularly worrying in resource-limited countries, particularly in sub-Saharan Africa (SSA). The prevalence of kidney disease appears to be higher with an estimated prevalence rate of 19.8% in West Africa (4). In 2010, 2.6 million individuals were receiving some form of kidney replacement therapy worldwide, but an almost equal number might have died during the same year because of a lack of access to dialysis and transplantation (5).
If we take Senegal as case study in SSA, the rate of the population on hemodialysis remains low, between 0 and 200 pmh (per million inhabitants). Many patients die due to lack of dialysis caused by a lack of resources (6). Many sub-Saharan African countries face enormous economic challenges in the care of patients with end-stage renal disease (ESRD); and this is due to the high cost of KRT.
La grande question que nous devons nous poser, professionnels de la santé ou non. Nos reins fonctionnent-ils normalement ? Pourquoi devons-nous nous poser cette question régulièrement ? Pourquoi ne nous posons-nous presque jamais cette question ?
Pour la première question, c’est parce que la maladie rénale est le grand « tueur silencieux ». Elle ne présente pratiquement aucun signe au début de la maladie. Lorsqu’elle est diagnostiquée par ses manifestations cliniques, elle est déjà avancée. La clé réside donc dans la prévention et le diagnostic précoce. Heureusement, nous avons aujourd’hui les moyens de le faire, mais le plus difficile est de les mettre en œuvre. Nous allons revenir sur ces moyens de prévention et sur les outils qui nous permettent aujourd’hui de faire un diagnostic précoce.
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