At present, there are almost 700,000 ESRD patients in Europe. And the burden of CKD is growing. During the past three decades, the incidence and prevalence of ESRD have risen progressively.4
At least 8% of the population of Europe currently has some degree of CKD and so it is estimated that at least 40 million people in the EU are affected. Furthermore, this figure is increasing each year and if the present trend is to continue, the number of people with CKD will double over the next decade.1 In America, one in nine people are estimated to have CKD and another 20 million are at risk of developing CKD which has resulted in fear that the disease is out of control. In fact, CKD is the 9th leading cause of death in the United States4 and on a European scale, the annual risk of death in CKD 5 patients is 10-100 times higher than the risk of death in the general population.1
The silent epidemic of CKD is a huge burden on national healthcare systems, with dialysis treatments alone accounting for 2% of national healthcare budgets.1 This figure is set to double in the next 5 years, without taking into account the wider costs in terms of additional medical expenses, decreased quality of life and life expectancy, increased morbidity and reduced capacity to work.1 Moreover, the costs involved with kidney disease are over four times what could be expected from the number of patients affected. Treating ESRD imposes a large economic burden on patients, healthcare systems and society.4 The cost of implementing CKD prevention strategies can be modest. 97% of health expenses are spent on treatment, only 3% on prevention. However, the cost of non-detection is enormous: for every person with kidney failure there are at least 30 people with lesser degrees of kidney damage who need treatment to minimise the risk of developing kidney failure.1
There is therefore an urgent need for improved public awareness, prevention strategies, early detection, education and subsequent management of CKD in clinical practice to deal with this growing and costly problem.1
Moreover, patients on renal replacement therapy currently face enormous problems: the access to, extent and quality of services for RRT varies greatly throughout the EU and most importantly opportunities for the best and most cost-effective treatment - renal transplantation - are severely restricted because of the significant shortage of donor kidneys.1