KUALA LUMPUR – The capital city of Kuala Lumpur saw a mammoth gathering of nephrologists from all over the world last week, where the annual scientific event, the World Congress of Nephrology’22 (WCN’22), offered the latest science and state-of-the-art highlights in the field of nephrology.
The four-day congress beginning on February 24 till 27 featured regionally relevant symposia, clinical presentations, training programmes, and continuing medical education courses with several Malaysian nephrologists and other allied experts also taking the podium.
It was officially launched by the Malaysian Minister of Health Khairy Jamaluddin on Friday.
The event was organised by the International Society of Nephrology (ISN) and hosted by the Asian Pacific Society of Nephrology and the Malaysian Society of Nephrology. Held at the Kuala Lumpur Convention Centre, the WCN’22 was also hosted virtually with a pre-congress session held from February 21-23.
Besides its educational purpose, WCN’22 also provided an ideal opportunity to meet experts and peers from around the world to share ideas and best practices.
But, as nephrologists gathered here to exchange notes – statistics present a grim picture of CKD, perceived by nephrologists as a worldwide scourge. WCN’22 noted that CKD is a global health burden with a high economic cost to health systems.
According to ISN, 850 million people across the world have some form of kidney disease and this number is progressively increasing. This figure is also roughly double the number of people who live with diabetes and 20 times more than the prevalence of cancer worldwide or people living with AIDS/HIV.
The prevalence of CKD worldwide is 10.4% among men and 11.8% among women. Acute kidney injury is experienced by 13.3 million people each year. This condition may resolve or lead to CKD or kidney failure in the future.
ISN also pointed out that globally between 5.3 and 10.5 million people need dialysis or transplantation – and many do not receive these treatments due to lack of resources or financial barriers.
The prevalence of CKD in Malaysia was 15.48% in 2018, an increase compared to the year 2011 when the prevalence of CKD was only 9.07%. An estimated 3.85% had stage 1 CKD, 4.82% had stage 2 CKD, and 6.48% had stage 3 CKD, while 0.33% had stage 4–5 CKD.
The estimated incidence of new dialysis patients in Malaysia in 2020 was 10,208 cases and is expected to surge to 19,418 in 2040.
Among the Malaysian speakers were:
– Dr Rafidah Abdullah, consultant physician, and nephrologist, Putrajaya Hospital. Rafidah spoke on palliative care among other subjects.
– Dr Sunita Bavanandan, head of nephrology at Kuala Lumpur Hospital, touched on the subject of changing practice with sodium-glucose co-transporter-2 inhibitors (SGLT2). SCLT2 is a prescription drug used with diet and exercise to lower blood sugar in adults.
– Professor Abdul Halim Abdul Gafor, consultant nephrologist of Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, spoke on the subject of dialysis “treatment trends from a global perspective”.
– Zulfitri Azuan Mat Daud of Universiti Putra Malaysia lent his views on nursing, nutrition, and “care of the whole person in CKD management”.
– Dr Tilakavati Karupaiah of Taylor’s University spoke on “nursing and nutrition: professional collaboration in the delivery of inter-professional care”, “gut to the kidney in experimental and clinical CKD” as well as overcoming the challenges of nutrition in low and middle-income countries.
– Professor Dr Christopher Lim of Universiti Putra Malaysia gave his views on non-renal indications for dialysis
– Dr Esther Tan, a consultant nephrologist at Selayang Hospital, shared her thoughts on hemodialysis and “Young nephrologists in action”.
– “Relationship between blood pressure control and treatment adherence among hypertensive patients was presented by nephrologist Shiong Yew of Mahkota Medical Centre, Malacca – whereas Dr Lily Mushahar of Tuanku Ja’afar Hospital presented on “Kidney health for all”.
– Dr Ong Loke Meng of Penang Hospital presented on the subject of “Setting the Scene: Challenges and Opportunities for Kidney Health Globally and in the Region”.
– Professor Dr Bak Leong Goh of Serdang Hospital presented his talk on ”Kidney Care: Challenges and Opportunities in Southeast Asia.
– Infectious disease expert Professor Adeeba Kamarulzaman of Universiti Malaya Medical Centre touched on the subject of how scientific progress in HIV and cancer has built a platform for rapid developments in Covid-19 research and how patient roles in these areas can help in kidney care.
Push for patient advocacy
WCN’22 also witnessed the launching session of the Patient Liaison Advisory Group (PLAG), which represents an inter-continental fraternity of kidney patients from 10 regions across the globe.
PLAG was established with a mission to advise and guide so that the patient perspective becomes coherently integrated within ISN’s work in shaping health initiatives and research programmes to tackle the global burden of CKD.
Speaking during the session, Malaysia’s well-known media personality, Manvir Victor – a kidney recipient – said: “With over 850 million people globally living with CKD, patients’ voices must be active and audible in designing and implementing the policies that directly affect their own lives.”
In 2002 when Manvir started dialysis management he was just another “inconspicuous CKD patient”.
He says: “There were no patient organisations that I could join, and I felt isolated as a result. This encouraged me to speak to other patients when I returned to the hospital for check-ups and I finally saw the need for a well-structured patient advocacy group.”
Today, Manvir has grown to become a patient advocacy leader not only in Malaysia and globally. He is chairman of Patients for Patient Safety Malaysia, World Health Organisation’s Patient Advocate, and an International Speaker on Communication and Integration for Healthcare Transformation Through Patient Engagement.
In his own words, Manvir, who is executive editor at The Vibes, shares his testimony on his life-changing experience:
“I had no idea I was at high risk for kidney disease until I received my diagnosis at the age of 34.
"The doctor said my creatinine levels were dangerously high, and my kidneys had deteriorated to the point of 75% – which meant that it was irreversible.
"My first doctor told me I had to go for dialysis immediately and let me add, in the worst possible and callous way, but after seeking more medical advice, I held off for a few months, thanks to another doctor who was very kind and patient.
"Many people didn’t understand how I had gotten ill so quickly. I was fine. I was playing sports, back then I was a radio DJ, I ran the number one radio programme in the country. None of this mattered as, like many people, I neglected to go for annual checkups.
"Everything came to a shuddering halt. When I started my dialysis in February 2002, I weighed about 86kg. By the end of the year, my weight dropped to about 70kg.
"My kidney condition hit me quite badly, both physically and mentally, to a stage where I couldn’t walk 100m without pausing. This continued for 10 long years and by the end of that period, I had been poked about 4,000 times with a needle.
"Now, I have a genuine fear of needles and can’t even see it happening on TV or to anyone else.
"In 2012, my wife donated one of her kidneys to me and this changed my life drastically.
"This second lease on my life makes me realise that together all of us can do more for others.
"And while contact sports like football are ruled out for me, I now go to the gym, swim, run and cycle every day. I try to keep myself as healthy as I can now by eating right and doing all I can to keep myself active.
"Apart from my other positions in patient advocacy, I am also a member of the National Patient Safety Council and part of the British Medical Journal international patient panel.
"It is my privilege to serve the public at large and educate ‘healthcare’ on the necessity of engaging the seven billion-plus people in the world to help the 50 million healthcare practitioners do their job.
"Healthcare needs help and there are so many impassioned patients who are willing to join and assist. Together with my other patient advocacy compatriots locally and internationally, we will continue to knock.” – The Vibes, March 4, 2022
