Is Dialysis Destiny?
Is Dialysis Destiny?
The number of adults aged 20-74 years who have chronic kidney disease (CKD), defined as glomerular filtration rate (GFR) of 15-59 mL/minute, increased from 2.6 million in 1978 to 3.9 million in 1991 in the United States. Although the precise number is not known, in 2004 up to 11% of the US adult population were thought to have CKD. The dreaded consequence of CKD is, of course, end-stage renal disease (ESRD) requiring dialysis or transplantation, which inflicts considerable human and economic burden on society. A recent study demonstrated that, in the United States, the incidence of ESRD is increasing faster than the prevalence of CKD. Similar trends are noted worldwide, showing that CKD is reaching epidemic proportions, posing a global health challenge. That CKD of diverse etiologies has a propensity to progress inexorably to ESRD independent of the underlying etiology has been recognized for nearly a half century. Unfortunately, progression to ESRD is not the only fate of the patient with CKD, who also faces increased risk of illness and death from cardiovascular disease (CVD).
The number of adults aged 20-74 years who have chronic kidney disease (CKD), defined as glomerular filtration rate (GFR) of 15-59 mL/minute, increased from 2.6 million in 1978 to 3.9 million in 1991 in the United States. Although the precise number is not known, in 2004 up to 11% of the US adult population were thought to have CKD. The dreaded consequence of CKD is, of course, end-stage renal disease (ESRD) requiring dialysis or transplantation, which inflicts considerable human and economic burden on society. A recent study demonstrated that, in the United States, the incidence of ESRD is increasing faster than the prevalence of CKD. Similar trends are noted worldwide, showing that CKD is reaching epidemic proportions, posing a global health challenge. That CKD of diverse etiologies has a propensity to progress inexorably to ESRD independent of the underlying etiology has been recognized for nearly a half century. Unfortunately, progression to ESRD is not the only fate of the patient with CKD, who also faces increased risk of illness and death from cardiovascular disease (CVD).
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