The HEALTH : April 2020 | Page 14

14 THE HEALTH | APRIL, 2020 | Insight | AN ALARMING RISE IN KIDNEY DISEASE PATIENTS However, the introduction of biosimilar products can bring some cost relief to many of these patients T HE incidence of Chronic Kidney Disease (CKD) among Malaysians is rising. If this trend continues, it will become the fi fth leading cause of deaths in the country by 2040. Among the main reasons are obesity, which increases the risk factor leading to diabetes, cardiovascular disease and hypertension. So, take care of your health if you don’t want to be part of these grim statistics. The message to Malaysians is clear; go for early screening as well as seek treatment for prevention. However, if you’re unfortunate to be struck by CKD, the good news is that the cost of treatment can now be reduced with biosimilar products. A biosimilar is a ratifi ed product that is produced based on an original product approved by the US Food and Drug Administration (USFDA). It is formulated from a cell line from living organisms and is therefore not identical with the original product but has a similar and equal eff ect. The Health spoke to four people on current renal disease issues, it’s prevention and the role of biosimilars in helping reducing treatment costs. These are their views. A healthy lifestyle will help prevent kidney disease BY CAMILIA REZALI A T THE rate the incidence of Chronic Kidney Disease (CKD) is increasing, it will soon be the fi fth leading global cause of death by 2040 and third in South East Asia, President of the Malaysian Society of Nephrology(MSN), Dr Sunita Bavanandan, underlined the probability saying the epidemiological trend of CKD prevalence in Malaysia has risen from 9.07 per cent in 2011 to 15.5 per cent in the years 2017-2018. This is due to the increasing prevalence of diabetes, obesity and the ageing population. CKD is a state of permanent loss of kidney function that occurs in fi ve stages. A person’s stage of CKD depends on the Glomerular Filtration Rate (GFR), which measures the fi ltration capacity of the kidney. End Stage Renal Disease (ESRD), on the other hand, is the most advanced stage where without dialysis and transplantation, a person can’t sustain life. “The major risk factors of CKD are diabetes, cardiovascular disease and hypertension. Obesity is also important as indirectly it is associated with these major CKD risk factors and directly, can also cause kidney damage” said Dr Sunita, who also heads the Department of Nephrology at Hospital Kuala Lumpur (HKL). “We should have a healthy lifestyle; exercise regularly and keep a balanced diet. Minimise salt consumption, be on a high-fi bre diet, drink lots of water and stop smoking. Going for regular screening is important because this disease lacks early-stage symptoms. Potentially nephrotoxic substances such as painkillers The registry data shows and herbal that in 2017 there are medications that 42,109 patients on renal have not been replacement therapy properly tested in Malaysia. must be avoided,” shared Dr Sunita. In Malaysia, the leading cause of ESRD is diabetes. This has remained unchanged the past few years, accounting from 65 per cent to 68 per cent of patients. The statistics on ESRD comes from recorded cases under the Malaysian Dialysis and Transplantation Registry. The registry data shows that in 2017 there are 42,109 patients on renal replacement therapy in Malaysia. A research projection based on the statistics from the local registry on kidney disease estimates more than 50,000 patients will be on dialysis by 2020. If the predicted trend is not corrected, there could be more than 100,000 patients on dialysis by 2040. The life expectancy of a patient with CKD depends on the primary cause, the other diseases which they may be suff ering from (co-morbidities) and whether they are managed optimally. Managing CKD at the advanced stage will either mean getting a kidney transplant, undergoing dialysis or palliative care. It is clear that there needs to be more focus on CKD prevention and detection in the earlier stages. This is where interventions will have the highest benefi ts for individuals and healthcare systems. —The Health FACT Obesity contributes indirectly to CKD by increasing the risks of diseases such as Diabetes, Hypertension, and Cardiovascular disease which cause CKD.” — Dr Sunita