Chronic kidney disease epidemics--a gap in effectiveness: the distance between potential and actual treatment...

Metabolic syndrome is a cluster of traditional risk factors including hypertension, abdominal obesity, hypertriglyceridemia, low HDL cholesterol and fasting hyperglycemia. This syndrome is a noxious condition not only for the cardiovascular (CV) system but also for the kidney. In a recent analysis of the NHANES III study the prevalence rate of chronic kidney disease (CKD) was very low in patients without risk factors, but reached 9% in those with five risk factors. Furthermore, in the NHANES III survey it was also found that mild renal insufficiency is frequent in the US population affecting about one-third of individuals. Recent estimates in Europe indicate that mild renal insufficiency is at least as frequent as it is in the US. While research on emerging risk factors in CKD is flourishing, clinical outcomes in these patients remain poor. This could depend on the fact that pathophysiological knowledge of the high renal and CV risk associated with CKD is still largely incomplete. Yet recent surveys have shown that treatment targets in these patients are largely unmet. Therefore, there is ample room for improving clinical outcomes in CKD by the systematic application of available treatments according to the recommendations of current clinical guidelines.