“7-8% of Italians discover late that they have kidney disease”

by time news

It is a silent pathology that does not cause pain, for this reason it is too often unknown and neglected. “Nevertheless chronic kidney disease affects 7-8% of the Italian population, men and women equally, and has a higher prevalence of diabetes mellitus. However, little is said about it because it is asymptomatic. As if that were not enough, the belief that chronic kidney disease is a rare clinical condition, caused by low prevalence diseases such as glomerulonephritis or some inherited diseases, is still deeply rooted, therefore a problem for a few unfortunate patients. ” Stefano Bianchi, elected president of the Italian Society of Nephrology (Sin) and director of Uoc Nephrology and Dialysis South Livorno Area, North West Tuscany Company, for which it is essential to sensitize the population, starting with the subjects most at risk, on the pathology and on the importance of an early diagnosis.

Chronic kidney disease, “Mrc – explains Bianchi – is a disease with a progressive course, defined as a condition of impaired kidney function or the presence of kidney damage when kidney function is still normal or slightly reduced, which persists for more than 3 months. So a chronic condition not related to an acute event. It can manifest itself in all stages of life, although it is a predominantly observable condition in old age. However, it does not spare the younger ones. The real problem is that it is an asymptomatic pathology, it does not manifest itself with major symptoms until the reduction of kidney function is extremely advanced. For this reason very often MCR is diagnosed too late, when anorexia, anemia, asthenia, cold sensation, shortness of breath appear, all non-specific symptoms that do not immediately recall the presence of a kidney disease “.

Among the risk factors responsible for kidney damage are diabetes mellitus, arterial hypertension, atherosclerotic vascular disease, dyslipidemia, overweight and obesity. “Modifiable factors on which it is possible to carry out preventive interventions – underlines the nephrologist – For this reason, in order to prevent this condition, it is important to promote adherence to correct lifestyles such as the absolute abstention from smoking, a moderate consumption of salt in the context of a Mediterranean-type diet, the performance of regular physical activity, the abstention from the assumption of potentially non-essential nephrotoxic drugs. All easily implemented rules, capable of preventing or in any case reducing the appearance of highly prevalent risk conditions in the population at risk. But among the risk factors we must not forget primary chronic kidney diseases linked to less easily preventable autoimmune or hereditary diseases“.

For the elected president of Sin it is important to talk about chronic kidney disease “first of all because its prevalence is much higher than is commonly perceived, even in health care settings – he specifies – It is believed that in the Western world about 10% of the general population have kidney disease, fortunately in most cases in the less advanced stages of the disease the MRC has a strong impact on the patient’s quality of life and on the National Health Service due to the high costs necessary to support the complex replacement therapies that are implemented in the terminal stages of the disease (dialysis and kidney transplantation) “.

Suffice it to think in this regard that “the resources destined for dialysis and transplantation – recalls Bianchi – in addition to those for the treatment of the disease still in conservative therapy, but now markedly evolved, are estimated for our NHS around the 2% of the entire funding for healthcare, a huge figure even considering that it is intended for a relatively small number of patients, when compared to the general population “.

Raising public awareness of the disease “is necessary – reaffirms the president-elect Sin – because we know that it is possible to implement strategies capable of diagnosing it in its initial phases or, in the intermediate ones, in which appropriate pharmacological therapies and hygienic-dietetic measures can slow down its progression, reducing the risk of resorting to dialysis or transplantation or at least postponing them over time, thus increasing the patient’s quality of life and at the same time reducing the cost of replacement therapy “. A not late approach to the patient with MRC, in fact,” allows programming of the beginning and type of replacement therapy, favoring the choice of home dialysis (peritoneal dialysis and hemodialysis), which is less expensive and more rehabilitative than hospital dialysis and above all preemptive transplantation, especially from a living donor “, adds the expert .

The diagnosis of Mrc is often difficult to obtain, but “its recognition and classification are simple – underlines Bianchi – thanks to inexpensive tests. A blood sample is sufficient for the determination of the creatininemia from which, using mathematical formulas, it is possible to calculate an estimated value of the glomerular filtration and the execution of a urine test on the first sample emitted in the morning which includes the determination of the albumin / creatinine ratio. Simple tests that must be carried out in all subjects at risk of developing chronic kidney disease (diabetics, hypertensive, elderly), with the aim of highlighting the disease in the earliest stages, which are completely asymptomatic “.

In terms of therapies “we have numerous options – the expert points out – pharmacological and non-pharmacological, capable of adequately treating chronic kidney disease. Adequate control of high blood pressure and diabetes when present, preferably using some drugs that have proved particularly nephroprotective, i.e. protective for the kidney, a correct nutritional approach from the early stages of the disease, the timely treatment of some complications, such as abnormalities of calcium-phosphorus metabolism and anemia, are nowadays measures important that must be known and implemented by all doctors who treat patients with MRC. And then hygiene-dietary measures to be adopted from early childhood: let’s remember that we are the EU country with the highest percentage of overweight and obese children is that we consume 3-4 times the salt we should take“.

A further element of optimism derives from the fact that “in recent years they have become available some classes of drugs that have shown remarkable efficacy in improving the renal and cardiovascular prognosis of patients, whether or not associated with the presence of type 2 diabetes. We have effective and safe weapons to treat the disease, even if the hope for the future is that of a world with fewer and fewer patients with kidney disease and above all without dialysis “, concludes the elected president Sin.

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