[An epidemiologic approach for the prevention of renal insufficiency]

Primary and secondary prevention of disease is among major goals of medicine. End stage renal disease (ESRD) is too expensive for society and its progression can be prevented or slowed down in many patients. In order to manage such an objective, clinical means as the search of urinary abnormalities and infection, as the measurement of plasma creatinin and microalbuminuria, the recording of blood pressure must help to create the nephrovigilance. Descriptive epidemiological data seem in favour of a progression of the incidence of ESRD due to development of vascular nephropathy, diabetes type II or toxic interstitial nephropathy. Analytic epidemiology studies suggest the implication of numerous environmental factors for progression of renal disease, whatever its type. Nephrologists, with preventive medicine, practitioners and other specialists, have to implicate themselves in the early diagnosis of renal diseases.