Renal failure isn't just a nephrologist problem

In the collective perception, uraemic patients are often identified as those undergoing dialysis. In reality, however, dialysis patients represent only a small fraction of the total uraemic population. Conservative estimates indicate that one in ten individuals in the industrialized world has some degree of renal dysfunction, meaning that approximately 700 million people are affected [GBD-Chronic Kidney Disease Collaboration. Global, regional, and national burden of Chronic Kidney Disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2020;395:709-33]. These figures have rapidly made chronic kidney disease (CKD)-the correct term for renal failure-a global public health issue, owing both to its unsustainable economic burden for healthcare systems and its high mortality rate, estimated at 2.6 million deaths in 2017 [Saran R, Robinson B, Abbott KC, Bragg-Gresham J, Chen X, Gipson D et al. US Renal Data System 2019 annual data report: epidemiology of kidney disease in the United States. Am J Kidney disease 2020;75:S1-S64]. To mitigate the impact of this true epidemic, new strategies must prioritize early detection and prevention. The first step, however, is conceptual: CKD should no longer be regarded as an exclusively nephrological disorder but as a multisystem condition requiring the attention of internists, cardiologists, diabetologists, and general practitioners alike.