Changing European CKD trends: a call to action.

Increasing numbers of patients with chronic kidney disease (CKD) who require renal replacement therapy threaten to overwhelm nephrologists, nephrology nurses, and haemodialysis units in many European countries. Health care costs are increasing more rapidly than corresponding budgets. These changing trends mandate new policies to provide continued quality care for more patients at international, national, and local levels. Although individual countries have different requirements regarding health care systems, approaches must be taken that improve structure, process, and outcome. Common issues include improving professional education, increasing collaboration among health care providers and specialists, and the acquisition and allocation of funds. Solutions identified by some countries provide examples of model programs that could be adapted for others. The impending crisis that more and older patients with serious comorbidities and CKD will impose on health care delivery must be addressed now in a proactive manner by the nephrology health care community.