[Epidemiology of CKD in Italy and prevention strategies]

Although chronic kidney disease (CKD) is a major health problem worldwide; it is not adequately considered in the strategies for the prevention of non-communicable diseases. To plan properly preventive strategies in our country, we need to know what is the prevalence of CKD, the risk factors, the level of awareness for the diagnosis, the referral to specialists nephrologists and the prognosis of patients followed in primary care. The prevalence of CKD, adjusted for age and gender, is 6.3% and the major independent risk factors are represented by old age, arterial hypertension, obesity, diabetes, cardiovascular disease and smoking . The awareness of the diagnosis in our country in 2003 is underestimated and nephrology referral for individuals with glomerular filtration (GF) under 60 ml / min was only 10%. The prognosis of patients, followed exclusively in primary care, worsens progressively for values of GF under 45 ml / min, both as need for substitutive treatment and mortality, compared with patients of stage I and II. To improve the management of CKD, it would be useful to set up an electronic database on our national territory by a network among laboratories, primary care, and nephrologists. An example of this organization is Great Britain that evidences encouraging results in the treatment and prevention of this debilitating disease.