Making chronic kidney disease a policy priority

Paula Pohja-Hutchison


Paula Pohja-Hutchison, Director, Global Government Affairs & Policy, CVRM

At AstraZeneca, we have the ambition to transform the way renal care is delivered to patients around the world and as the Director of Global Government Affairs & Policy within our Cardiovascular, Renal and Metabolism (CVRM) therapy area, I am eager to make this vision a reality.

When beginning my work in CVRM, I was shocked to know that across the world, 200 million people are living with diagnosed chronic kidney disease (CKD).1 The burden of the disease is growing; by 2040, CKD is expected to become the fifth leading cause of mortality around the world.CKD is a consequence of other non-communicable diseases such as diabetes, hypertension or inflammation, which, taken together, are posing a major challenge to health care systems across the world. 

Health policies developed by national governments can deliver strategies and funding to support equitable access to standardised, high quality health services, and these are needed to support improvements in care for patients with CKD. However, the Global Kidney Health Atlas 2019 found that more than half (53 percent) of the countries surveyed did not have a national strategy for improving CKD care.3 While CKD is a disease area that has seen little innovation over the last 30 years, there are potential scientific breakthroughs on the horizon that could significantly improve patient outcomes and patients’ lives. Yet, from my experience, I know any breakthroughs will not translate into major impact if the systems are not in place to ensure patients can benefit.

The costs of managing end-stage renal disease (ESRD) are staggering:

  • It is estimated that annual costs of dialysis and kidney transplant range between $35,000 and $100,000 per patient 4
  • Dialysis alone accounts for $14 billion per year to EU health systems, 2% of health care budgets in the EU 5
  • In the US, those who live with ESRD account for 1% of the US Medicare population but 7% of the budget 6
  • In China, the economy will lose $558 billion over the next decade due to effects on death and disability attributable to chronic cardiovascular and renal disease. 7

Yet, despite these significant burdens to patients and societies, CKD is rarely prioritised by national or global decision makers. I’m confident in the potential to mitigate against these costs if we implement effective strategies for prevention, early identification and effective management of CKD. National policy action would support better delivery of care and effective treatments, which could slow progression of CKD in high-risk patients, reduce the risk of cardiovascular mortality and make financial savings for health systems.

There is a significant unmet need in the management and treatment of CKD and its complications. While AstraZeneca aims to change the future of renal care, we cannot do this alone. Meaningful improvements require deeper collaboration with partners from patient communities, clinicians and policymakers to ensure we have the right policies in place to meet the needs of patients for better and more effective care, pathways and experiences. I look forward to being a part of the solution for patients.


    1. Ojo A et al, ‘Addressing the global burden of chronic kidney disease through clinical and translational research’, Trans Am Clin Climatol Assoc, 2014, 125: 229-246

    2. Foreman KJ et al, ‘Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016–40 for 195 countries and territories’, The Lancet 2018, volume 392 issue 10159, pages 2052-90

    3. International Society of Nephrology, Global Kidney Health Atlas 2019 Last accessed 2 October 2019

    4. Levin A et al, ‘ Global kidney health 2017 and beyond: a roadmap for closing gaps in care, research, and policy’, The Lancet, 2017, volume 390 issue 10105, pages 1888-1917

    5. European Renal Care Providers Association, Facts and figures. Last accessed 4 October 2019

    6. University of California San Francisco, The Kidney Project, Last accessed 4 October 2019

    7. World Kidney Day, Chronic Kidney Disease, Last accesses 4 October 2019