title: [How to slow the progression of kidney damage today. Chronic kidney disease: an important personal, family and social problem].
abstract: The number of patients with chronic kidney disease (CKD) is increasing worldwide like an unstoppable tsunami. This causes considerable suffering for patients and families and places a severe economic burden also on society, especially when the patient reaches the stage of being in need of renal replacement therapy. Accordingly, a program of prevention and treatment of CKD at its earlier stages is of great importance, also in view of the fact that the general population is getting older and older and is more frequently affected by comorbidities such as hypertension, diabetes, obesity and cardiovascular disease. All these factors increase the likelihood of the development and worsening of CKD. In the meantime, nephrologists have developed new and better strategies to halt or at least slow the progression of CKD. These are based on the prescription to quit smoking and on dietary interventions guaranteeing an adequate calorie, protein, phosphate and sodium intake together with the correction of metabolic acidosis through either the supplementation of sodium bicarbonate or the choice of basic proteins. The treatment of hypertension and proteinuria (when detectable) by means of RAS inhibitors is another important strategy, where partial correction of anemia and statin use may be of help. Other treatments have not proven to be effective or their introduction into clinical practice is still far away.
authors.affiliation: Dipartimento di Nefrologia, Dialisi e Trapianto Renale, Azienda Ospedaliera della Provincia di Lecco, Ospedale ''Alessandro Manzoni'', Lecco - Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Locatelli
authors.forename: Benedetta
authors.initials: B
authors.lastname: Tucci
authors.forename: Lucia
authors.initials: L
authors.lastname: Del Vecchio
mesh_terms: D017281:Cost of Illness; D018450:Disease Progression; D005190:Family; D006801:Humans; D051436:Renal Insufficiency, Chronic / Q000517:prevention & control*; D066252:Sociological Factors