[Il progetto PIRP: un'intuizione di vent'anni fa, oggi più che mai attuale]

The PIRP Project (Progressive Renal Insufficiency Prevention), launched in Emilia-Romagna in the early 2000s, was created to establish a network between general practitioners and nephrologists aimed at the early identification of chronic kidney disease (CKD), slowing its progression, and improving clinical outcomes. The project included several phases: a training phase for general practitioners, the establishment of dedicated outpatient clinics, and the creation of a regional electronic registry, which today includes more than 38,000 patients. The results have shown a reduction in CKD progression, fewer urgent dialysis starts, and better control of comorbidities. PIRP differs from the national PDTA for CKD in its operational and regional approach, based on real-world data and multidisciplinary co-management, whereas the PDTA represents a general regulatory framework. The project has developed predictive models (such as CT-PIRP), inspired comparative European studies, and today stands as a model of integrated healthcare, useful for the implementation of nephroprotective drugs and artificial intelligence. Twenty years after its inception, PIRP remains an example of proactive and collaborative medicine, anticipating modern paradigms of population health management.