Prevalence and socio-economic aspects of chronic kidney disease.

The incidence and prevalence of end-stage renal disease (ESRD) are rising in Europe, the USA, and Japan. Prevalence is rising more steeply than incidence, due mostly to improved efficiency of treatment -patients are surviving longer. Hypertension and diabetes, the main causes of progression from chronic kidney disease (CKD) to ESRD, are becoming more frequent in the general population and make a large contribution to the rising incidence of ESRD. More effective therapies for other conditions have introduced new complications for patients with CKD, thereby also increasing the incidence of ESRD. Increased survival in the general population is reflected in the greater number of elderly people requiring care for ESRD. ESRD is a great economic burden and one that will increase as the incidence and prevalence of the disease increase. This needs to be considered when planning treatment. Prevention and early treatment of hypertension and diabetes will have the greatest impact on the future prevalence of ESRD and the costs associated with its treatment.