The changing patterns of chronic kidney disease: the need to develop strategies for prevention relevant to different regions and countries.

Chronic diseases are now in pandemic proportions and are the major cause of morbidity and mortality worldwide. Long-term predictions show that the burden will fall increasingly on developing countries. Type II diabetes is now the major global cause of chronic kidney disease. However, chronic kidney disease should not be viewed in isolation, because it is also a major risk factor for cardiovascular deaths. It is both a medical and economic imperative to introduce screening and management programs for chronic kidney disease, diabetes, hypertension, and cardiovascular disease worldwide but particularly in the emerging world. Such programs should be tailored to the needs of the individual country, involve local health providers, be assessable as to their efficacy, and become self-sufficient within 5 years.