Patrik Finne, Elena Zakharova, Christoph Wanner, Raymond Vanholder, María José Soler, Inga Arūnė Bumblytė, Ziad A. Massy, Halima Resić, Bénédicte Stengel, Annette Bruchfeld, Kitty J Jager, Vladimír Tesař, Mario Cozzolino, Kate Stevens, Peter J. Blankestijn, Goce Spasovski, Mehmet Sukru Sever, Ivan Rychlik, Myftar Barbullushi, Carmine Zoccali, Andrzej Wiecek, Dimitris Goumenos, Jérôme Harambat, Institut Català de la Salut, [Sever MŞ] Department of Nephrology, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey. [Jager KJ] ERA-EDTA Registry, Department of Medical Informatics, Amsterdam Public Health Research Institute Amsterdam, Noord-Holland, The Netherlands. [Vanholder R] Nephrology Section, Department of Internal Medicine and Pediatrics, University Hospital Ghent, Gent, Belgium. European Kidney Health Alliance (EKHA), Brussels, Belgium. [Stengel B] UVSQ, University Paris-Saclay, University Paris-Sud, Inserm, Clinical Epidemiology Team, CESP, Villejuif, France. [Harambat J] UVSQ, University Paris-Saclay, University Paris-Sud, Inserm, Clinical Epidemiology Team, CESP, Villejuif, France. Pediatric Nephrology Unit, Bordeaux University Hospital, Bordeaux, France. [Finne P] Helsinki University Central Hospital, Division of Nephrology, Helsinki, 00029, Finland. [Soler MJ] Servei de Nefrologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus, Department of Medicine, Clinicum, Nefrologian yksikkö, HUS Abdominal Center, Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), and University of Milan
Chronic renal failure; Dialysis; Kidney transplantation Insuficiència renal crònica; Diàlisi; Trasplantament de ronyó Insuficiencia renal crónica; Diálisis; Trasplante de riñón Chronic kidney disease (CKD) is a major health problem because of its high prevalence, associated complications and high treatment costs. Several aspects of CKD differ significantly in the Eastern European nephrology community compared with Western Europe because of different geographic, socio-economic, infrastructure, cultural and educational features. The two most frequent aetiologies of CKD, DM and hypertension, and many other predisposing factors, are more frequent in the Eastern region, resulting in more prevalent CKD Stages 3–5. Interventions may minimize the potential drawbacks of the high prevalence of CKD in Eastern Europe, which include several options at various stages of the disease, such as raising public, medical personnel and healthcare authorities awareness; early detection by screening high-risk populations; preventing progression and CKD-related complications by training health professionals and patients; promoting transplantation or home dialysis as the preferred modality; disseminating and implementing guidelines and guided therapy and encouraging/supporting country-specific observational research as well as international collaborative projects. Specific ways to significantly impact CKD-related problems in every region of Europe through education, science and networking are collaboration with non-nephrology European societies who have a common interest in CKD and its associated complications, representation through an advisory role within nephrology via national nephrology societies, contributing to the training of local nephrologists and stimulating patient-oriented research. The latter is mandatory to identify country-specific kidney disease–related priorities. Active involvement of patients in this research via collaboration with the European Kidney Patient Federation or national patient federations is imperative to ensure that projects reflect specific patient needs. The treatment of kidney failure is costly, therefore financial support from governments is essential to ensure that all patients receive appropriate treatment. This imposes a major burden on the economy. According to the World Bank, only 74% of governments in Eastern and Central Europe provide full support for KRT [7]. Funding of treatment in earlier stages of CKD is even more problematic because of the high number of patients and because the diagnosis may not be made in a timely manner. Although no objective data are available, it is very likely that public funding at earlier stages of CKD is less common or, at least, less comprehensive than reimbursement of KRT.