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Paul Jungers, Screening for renal insufficiency: is it worth while? is it feasible?, Nephrology Dialysis Transplantation, Volume 14, Issue 9, September 1999, Pages 2082–2084, https://doi.org/10.1093/ndt/14.9.2082
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Increasing incidence of progressive renal insufficiency is a major public health problem
The relentlessly rising incidence of end-stage renal failure (IRF) is a major problem for all public health systems in Western countries. For more than 10 years, the number of new patients accepted on renal replacement therapy (RRT) has been increasing by about 9% per year in the USA [1], and the increment in most European countries is at least about 4% per year. In consequence, the prevalence of patients on dialysis is continuously growing, inasmuch as it is not compensated for by a corresponding annual number of kidney transplantations, and constitutes a heavy burden for national health budgets.
The growing annual incidence of ESRD patients requiring RRT is chiefly due to the increasing number of patients with diabetic nephropathy and hypertensive vascular disease, because better treatment of diabetes and hypertension means that a greater proportion of affected patients live longer, and develop renal complications. Therefore, the increasing incidence of ESRD appears inexorable, unless early, adequate management of patients is able to prevent the development of renal disease, or at least slow progression of renal insufficiency. However, a number of patients with renal disease do not benefit from the therapeutic options available today, chiefly because they are not referred to the nephrologist early enough.
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