Need for chronic kidney disease prevention programs in disadvantaged populations.

Chronic kidney disease (CKD) is a key determinant of the poor health outcomes for major non-communicable diseases that are the leading cause of death in the world. CKD is a worldwide threat to public health, but the size of the problem is not fully appreciated. Early recognition of CKD and concomitant co-morbid conditions, can potentially slow progression to renal failure, increase longevity, improve quality of life, and reduce healthcare costs. Although screening programmes are attractive, there is no consensus yet on which individuals should be prioritized (high-risk group for CKD, or general population) especially in resourcepoor regions. In these settings there is not a unique blueprint of screening strategy, so that the approaches should be adapted on single-nation conditions and socioeconomic status. Effective multimodal tools are available to prevent CKD by managing its risk factors, and to slow or even halt disease progression to end-stage renal failure, as well as reduce the associated risk of cardiovascular morbidity and mortality. They can be adapted even to the poorest populations who are at the highest risk of CKD. Where management strategies have been implemented, the incidence of end-stage renal disease (ESRD) has been reduced. The hope is that all these efforts will assist to make major advances in addressing the neglected aspect of renal health, especially of poor and disadvantaged populations worldwide. Beside saving young lives, such action would minimize the present health inequity that arises mainly from the unaffordable cost of renal replacement therapy if ESRD is not prevented.