Mind the Gap Between Estimated Needs and Current Resources in Chronic Kidney Disease

Background/Objectives: In recent decades, chronic kidney disease (CKD) has increased its prevalence in the general population, reaching about 10%. The increasing number of older patients and the expansion of treatment options could necessitate a growing number of nephrologists/nurses. This report aims to estimate the resources required to manage the CKD population and hypothesize possible strategies to address the discrepancy between the estimated need and available resources. Methods: Based on previous reports about CKD in our geographic area and the data reported by the Italian Statistics Institute (ISTAT), we estimated the number of patients who should be referred to a nephrologist in our district, and consequently the number of nephrology consults and the need of nephrologists (considering 14 visits for 5 days/week, 48 weeks/year for each nephrologist). Results: The Padua district has approximately 240,257 inhabitants aged 40 years and older. Of these, 31,139 are estimated to have CKD, and 540 are potentially affected by CKD stage 5. The estimated number of outpatient visits is approximately 178 per day, which would require 12 full-time employed nephrologists. On the contrary, only two nephrologists are currently involved full-time in outpatient clinics, while eight are involved part-time. Finally, 540 CKD G5 surpasses the current available dialysis seats (184 hemodialysis seats and 80 peritoneal dialysis seats). Conclusions: In the Padua Healthcare district, the estimated outpatient clinic demand and the potential need for renal replacement therapy exceed human and facility resources, indicating a need for nephrologists in outpatient clinics that is more than four to six times the current numbers. This discrepancy highlights the need for a multidimensional approach that promotes active collaboration with general practice, telemedicine, and an informative campaign targeting the population.