Nephrology and Dialysis Unit, "St. Marta and St. Venera" Hospital, Acireale, Italy.
Renal Unit, "Magna Graecia" University of Catanzaro, Catanzaro, Italy.
Ther Apher Dial. 2021 Apr;25(2):136-144. doi: 10.1111/1744-9987.13556. Epub 2020 Aug 18.
Chronic kidney disease (CKD) is an increasing public health problem. Aging is one of the leading causes, particularly in Western countries, but several comorbidities, such as hypertension and diabetes are involved in its pathogenesis. Thus, the treatment of CKD patient is very complex and requires an integrated strategy. In this context, the holistic approach to the CKD patient and not to the disease itself should be the answer. General practitioners, specialists, voluntary associations, and nonprofit organizations, in addition to the family of the patient, all contribute to the patient care. Moreover, due to the low sensitivity of creatinine values in the early stages of renal failure, its diagnosis often occurs in the advanced phases of the disease. Therefore, the health costs for CKD patients are hardly sustainable by health systems. The reorganization of economic and epidemiological data through new models is necessary to allow the sustainability of the system and to ensure medical care for all patients. In this review, we aim to deal with all the issues about patient care, standards of care, and the impact of chronicity from a global perspective in light of the current state of the Italian healthcare system.
慢性肾脏病（CKD）是一个日益严重的公共卫生问题。老龄化是主要原因之一，特别是在西方国家，但也涉及到一些合并症，如高血压和糖尿病，参与其发病机制。因此，CKD 患者的治疗非常复杂，需要综合治疗策略。在这种情况下，对 CKD 患者的整体治疗方法，而不是针对疾病本身，应该是解决问题的答案。全科医生、专家、志愿协会和非营利组织，以及患者的家人，都为患者的护理做出了贡献。此外，由于肾衰竭早期肌酐值的敏感性较低，其诊断通常发生在疾病的晚期。因此，CKD 患者的医疗费用对卫生系统来说几乎是不可持续的。通过新模型对经济和流行病学数据进行重新组织是必要的，以确保系统的可持续性，并为所有患者提供医疗保健。在这篇综述中，我们旨在从全球的角度出发，根据意大利医疗保健系统的现状，处理与患者护理、护理标准以及慢性疾病相关的所有问题。
