ERA’s ABCDE framework for kidney disease prevention: turning the WHO kidney health resolution into action

TL;DR

This paper outlines a framework for preventing kidney disease by aligning global health initiatives with actionable strategies like monitoring key health indicators.

Contribution

The paper introduces the ABCDE framework as a novel approach to kidney disease prevention, aligned with global health resolutions.

Findings

The WHO and UN have prioritized kidney health alongside major NCDs.

The ABCDE framework is proposed for early detection and treatment of CKD.

Cardiovascular disease mortality is decreasing, unlike CKD mortality.

Abstract

In 2025, the World Health Assembly of the World Health Organization (WHO) adopted a resolution on reducing the burden of noncommunicable diseases (NCDs) by promoting kidney health and strengthening the prevention and control of kidney disease. Following the WHO resolution, the United Nations (UN) included kidney health in its 2025 Political Declaration on NCDs. These measures are a clear response to the growing burden of kidney diseases. This achievement for kidney health was facilitated by years of effort by multiple stakeholders and decision-makers, including nephrology associations, particularly the International Society of Nephrology, the European Renal Association (ERA) and the American Society of Nephrology, gathering evidence on the growing burden of chronic kidney disease (CKD), raising awareness of this burden, advancing research and innovation, and adopting scientific and policy recommendations for the early detection, prevention and treatment of CKD. The WHO and UN measures add kidney disease to a list of major NCDs (e.g. cancer, cardiovascular diseases, diabetes, respiratory diseases) that should be prioritized by healthcare systems. The kidney health resolution is fully aligned with the ERA’s activities and recommendations, as well as with the 2025 KDIGO document on the prevention of CKD and maintenance of kidney health. This novel preventive approach has been tried and tested for other conditions, such as cardiovascular disease, the age-adjusted mortality of which is falling dramatically, compared with the equally dramatic increase in CKD mortality. The next step would be to define an actionable condition of very high risk of CKD, that may be termed pre-CKD. This should be complemented by programs for the early diagnosis and treatment of CKD, such as the one promoted by ERA’s ‘Protect Your Kidneys, Protect Your Future’ campaign which emphasizes the need to know and treat the ABCDE numbers (Albuminuria, Blood pressure, Cholesterol, Diabetes, Estimated glomerular filtration rate) to improve cardiovascular–kidney–metabolic health.

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