Prevention of chronic kidney and vascular disease: toward global health equity--the Bellagio 2004 Declaration.
Chronic kidney disease (CKD) not only reflects target organ injury in systemic vascular disease in the general population and in association with diabetes, hypertension, and smoking, but it is recognized as one of the major risk factors in the pathogenesis and outcome of cardiovascular disease. Recent surveys have revealed that the prevalence of CKD, particularly the hidden mild form (mildly elevated levels of serum creatinine or urinary albumin excretion), is surprisingly high in the general population. In recent years, the global epidemic of type 2 diabetes has led to an alarming increase in the number of patients with CKD. Most patients with CKD (over 50 million individuals worldwide) succumb to cardiovascular events, while each year over 1 million develop end-stage renal failure, which requires costly treatment and in many countries of the world, unaffordable renal replacement therapy by chronic dialysis or renal transplantation. Alarmed by the immense challenge to human morbidity and the economic burden of CKD and ensuing systemic cardiovascular disease, the International Society of Nephrology convened a multidisciplinary group of expert physicians and public health leaders from around the world to develop strategies to delay and avert this bleak future by effective prevention of CKD based on awareness, early detection, and effective treatment.
Dirks
John H
JH
Massey College, Ontario, Toronto, Canada.
de Zeeuw
Dick
D
Agarwal
Sanjay K
SK
Atkins
Robert C
RC
Correa-Rotter
Ricardo
R
D'Amico
Giuseppe
G
Bennett
Peter H
PH
El Nahas
Meguid
M
Valdes
Raul Herrera
RH
Kaseje
Dan
D
Katz
Ivor J
IJ
Naicker
Sarala
S
Rodriguez-Iturbe
Bernardo
B
Schieppati
Arrigo
A
Shaheen
Faissal
F
Sitthi-Amorn
Chitr
C
Solez
Kim
K
Viberti
Giancarlo
G
Remuzzi
Giuseppe
G
Weening
Jan J
JJ
D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D014943:Global Health; D006801:Humans; D007391:International Cooperation; D007676:Kidney Failure, Chronic / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D009398:Nephrology; D012955:Societies, Medical