Abstract

Chronic kidney disease (CKD) is a public health problem worldwide. CKD is often under-diagnosed and under-treated. CKD affects many more people than we would even imagine: one out of 10 adults in the world has some form of kidney damage. The main causes of CKD are glomerulonephritis, diabetes and hypertension. Early detection and prevention of the progression of CKD for people who have also a very high cardiovascular risk are extremely important. CKD represents a progressive, irreversible decline in glomerular filtration rate. Adaptive hyperfiltration, although initially beneficial, appears to result in long-term damage to  the glomeruli of the remaining nephrons, which is manifested by proteinuria and progressive renal insufficiency. Most chronic nephropathies unfortunately lack specific treatment and progress relentlessly to end stage renal disease. As a result, a patient with mild renal insufficiency often has a normal or near-normal serum creatinine concentration.
The National Kidney Foundation–Kidney Disease Outcomes Quality Initiative work group has defi ned CKD and worked out a new 5-stage classification in 2002 which was accepted internationally by the International Society of Nephrology, with some modifications made in 2005.