Part,  Chapter, Paragraph

 1   II,     5.  1.  1|           to be the main drivers of CKD at population level. Patients
 2   II,     5.  1.  1|        drugs are at higher risk for CKD. Currently, diabetes mellitus
 3   II,     5.  7.Acr| Atherosclerosis Risk in Communities~CKD~Chronic Kidney Disease~ESRD~
 4   II,     5.  7.  1|             Chronic kidney disease (CKD) is increasingly recognized
 5   II,     5.  7.  1|        major public health problem. CKD can be detected via simple
 6   II,     5.  7.  1|           GFR) (Levey et al, 1999). CKD is now described based on
 7   II,     5.  7.  1|             adult Americans exhibit CKD (Coresh et al, 2005 ). Estimates
 8   II,     5.  7.  1|         these studies indicate that CKD is of concern also in EU
 9   II,     5.  7.  1|       concern also in EU countries. CKD is a dangerous clinical
10   II,     5.  7.  1|             patients with stage 4-5 CKD have a death risk for cardiovascular
11   II,     5.  7.  1|         stage renal disease (ESRD),~CKD was not listed among chronic
12   II,     5.  7.  1|           evidence is emerging that CKD is a risk factor for death
13   II,     5.  7.  1|           to frame the link between CKD and other chronic diseases
14   II,     5.  7.  1|         useful for the screening of CKD; indeed, studies are currently
15   II,     5.  7.  1|      Development and progression of CKD.~ ~ESRD and the resulting
16   II,     5.  7.  1|         countries have policies for CKD. The high prevalence of
17   II,     5.  7.  1|              The high prevalence of CKD, its contribution to cardiovascular
18   II,     5.  7.  1|      resources, full recognition of CKD as a preventable disease
19   II,     5.  7.  1|             important issue. Indeed CKD prevention may also help
20   II,     5.  7.  1|             in developed countries. CKD is very common in people
21   II,     5.  7.  1|        reasons, health policies for CKD need to be harmonized with
22   II,     5.  7.  1|          diseases.~ ~Information on CKD in the pre-ESRD phases in
23   II,     5.  7.  1|        Available data indicate that CKD at this age is rare (Ardissino
24   II,     5.  7.  1|           in Europe. Although rare, CKD and ESRD in children pose
25   II,     5.  7.  1|   development.~ ~Economic Impact of CKD~ ~Apart from the morbidity,
26   II,     5.  7.  1|       quality of life engendered by CKD and ESRD both in adults (
27   II,     5.  7.  1|          indirect costs to society. CKD in the pre ESRD phase entails
28   II,     5.  7.  1|              Whenever possible, the CKD data are presented according
29   II,     5.  7.  1|            1 and 5.7.2). Data about CKD in children are presented
30   II,     5.  7.  1|                Table 5.7.2. Current CKD Classification Based on
31   II,     5.  7.  2|        studies on the prevalence of CKD among children, adolescents
32   II,     5.  7.  2|           data on the prevalence of CKD (stages 1-5) in EU countries
33   II,     5.  7.  2|           at a recent convention on CKD in European countries made
34   II,     5.  7.  2|       presentations. Trend data for CKD are very scarce.~ ~In quite
35   II,     5.  7.  3|          Children and adolescents~ ~CKD in the pre-ESRD phases in
36   II,     5.  7.  3|          shown an incidence rate of CKD (defined as a GFR <75 ml/
37   II,     5.  7.  3|            Table 5.7.3).~ ~Adults~ ~CKD incidence in adults has
38   II,     5.  7.  3|           the incidence rate of 3-5 CKD was 7.8 per 1000 patients
39   II,     5.  7.  3|          data concerning changes in CKD over time, whilst the correlation
40   II,     5.  7.  3|       faster than that observed for CKD (Hsu et al, 2004). Indeed,
41   II,     5.  7.  3|             prevalent patients with CKD in 1978. By comparison,
42   II,     5.  7.  3|            every 1000 patients with CKD in 1991. A similar finding
43   II,     5.  7.  3|           the relative stability of CKD versus a marked increase
44   II,     5.  7.  3|           Norway. Prevalence of 1-5 CKD in Norway was 10.2% which
45   II,     5.  7.  3|           risk for progression from CKD stages 3 or 4 to ESRD in
46   II,     5.  7.  3|    information on the trends of the CKD incidence rate in children/
47   II,     5.  7.  3|        surveys on the prevalence of CKD among adults are available
48   II,     5.  7.  3|          still a paucity of data on CKD. Data in Europe have been
49   II,     5.  7.  3|            prevalence of stages 3-5 CKD was 1.3 to 1.5 times higher
50   II,     5.  7.  3|             prevalence of stage 3-5 CKD appears reasonably similar
51   II,     5.  7.  3|            The higher prevalence on CKD in females, which flies
52   II,     5.  7.  3|        adolescents~ ~Information on CKD in the pre-ESRD phases for
53   II,     5.  7.  3|            reported a prevalence of CKD (defined as a GFR <75 ml/
54   II,     5.  7.  3|            GFR cut-off for defining CKD (<30 ml/min per 1.74 m2 ),
55   II,     5.  7.  3|          Adults~ ~The prevalence of CKD by stages (as defined in
56   II,     5.  7.  3|            Prevalence of stages 3-5 CKD - i.e. the stages showing
57   II,     5.  7.  3|             et al, 2007). Stage 3-5 CKD prevalence was either similar
58   II,     5.  7.  3|             prevalence of stage 3-5 CKD increased with age (Figure
59   II,     5.  7.  3|       information on time-trends of CKD. The most solid source of
60   II,     5.  7.  3|             prevalence of stage 1-5 CKD rose from 14.5% (NHANES
61   II,     5.  7.  3|            the risk of mortality in CKD rises exponentially with
62   II,     5.  7.  3|          still a paucity of data on CKD. Data in Europe have been
63   II,     5.  7.  3|             prevalence of stage 3-5 CKD was 1.3 to 1.5 times higher
64   II,     5.  7.  3|             prevalence of stage 3-5 CKD appears reasonably similar
65   II,     5.  7.  3|            The higher prevalence on CKD in females, which flies
66   II,     5.  7.  4|           to be the main drivers of CKD at population level. Patients
67   II,     5.  7.  4|        drugs are at higher risk for CKD.~ ~There are no data on
68   II,     5.  7.  4|           socio-economic status and CKD. It is likely that these
69   II,     5.  7.  4|            also the main drivers of CKD, it appears likely that
70   II,     5.  7.  4|          factors are also linked to CKD. According to data from
71   II,     5.  7.  5|          the general population for CKD is cost-effective (Boulware
72   II,     5.  7.  5|           those individuals in whom CKD acts as a risk amplifier)
73   II,     5.  7.  5|              are at higher risk for CKD. When the risk of complications
74   II,     5.  7.  5|            neoplasia, screening for CKD appears advisable. Both
75   II,     5.  7.  5|           infections, screening for CKD could be implemented using
76   II,     5.  7.  5|         incidence and the course of CKD. The only activities to
77   II,     5.  7.  5|          epidemiological problem of CKD have been related to the
78   II,     5.  7.  5|          2007 a programme to detect CKD in an early phase was presented
79   II,     5.  7.  5|             is no single agenda for CKD and ESRD at national level,
80   II,     5.  7.  5|    prescription in order to improve CKD diagnosis. Policies regarding
81   II,     5.  7.  5|        evaluation of care including CKD are currently in progress.~·
82   II,     5.  7.  5|             Statistica did not list CKD among chronic diseases.
83   II,     5.  7.  5|         survey on the prevalence of CKD at community level has been
84   II,     5.  7.  5|            renal services. Although CKD has hitherto been an under-diagnosed
85   II,     5.  7.  5|             and the introduction of CKD into the Quality and Outcomes
86   II,     5.  7.  5|           they manage patients with CKD. This helps ensuring that
87   II,     5.  7.  5|           people are diagnosed with CKD, they get high quality advice
88   II,     5.  7.  5|          people were diagnosed with CKD, creating an opportunity
89   II,     5.  7.  5|   life-saving advice and treatment. CKD receives 27 points in QOF,
90   II,     5.  7.  5|            national action plan for CKD, including secondary prevention,
91   II,     5.  7.  5|           public health policies on CKD or RRT in Estonia and Sweden.
92   II,     5.  7.  6|             community management of CKD, including self-care and
93   II,     5.  7.  6|           this kind of policies for CKD. The development of these
94   II,     5.  7.  6|       including full recognition of CKD as a preventable disease
95   II,     5.  7.  6|    introduction, these policies for CKD will need to be harmonized