Just under 1 in 10 Italians suffer from one chronic kidney disease, but in most cases it is not aware of it. This is because it is a mostly asymptomatic pathology up to the advanced stages, which often leads to a late diagnosis and, consequently, less effective therapies. And yesterday the preliminary work was carried out in the Senate for the update of the Policy document on chronic kidney disease (CRM), the most frequent chronic-degenerative disease in our country. The event, promoted by Sin on the initiative of Senator Ignazio Zullo (Fdi), set itself the objective of taking a snapshot of the implementation of the existing Pdta and of taking stock of the updating of the guidelines for chronic kidney disease in synergy with the Ministry of Health, the Federation of Italian Medical-Scientific Societies (Fism), the Italian Society of General Medicine and Primary Care (Simg) and the National Association of Hemodialysis, Dialysis and Transplant Patients (Aned).
The last address document on the CRM – reports a note – dates back to 2014 (with the approval of the State-Regions Conference), for which an update was necessary, also considering the particularly high costs that determines the CRM from the point of economic, social and human point of view. In fact, in the terminal phase of the disease, it is necessary to intervene with substitution therapies, dialysis and transplants, which have a major impact on the quality of life of citizens, require a complex organization and involve huge health costs.
“The MRC absorbs over 3% of the entire funding of our NHS – said Stefano Bianchi, president of the Italian Society of Nephrology, during the event ‘Challenges and objectives for a new management of chronic kidney disease’ – It results therefore the need for a strong collective commitment in the prevention and early diagnosis of the disease is evident, which must be actively sought, with simple and inexpensive tests, starting from the populations most at risk such as diabetics, hypertensives, heart patients, the obese. actors in a trend reversal and a “proactive” attitude, developing and implementing programs of primary prevention, early diagnosis and adequate treatment, which moreover today makes use of new, effective and safe therapies”. This “is the way forward for move towards a world with less and less dialysis and more and more renal health – added Bianchi – a long-term investment, also taking into account that renal disease is accompanied by a significant increase in cardiovascular morbidity and mortality”.
The work in the Senate – continues the note – highlighted the state of implementation of the guidelines at the regional level and outlined interventions for prevention, early diagnosis and effective management of the CMR.
The conference was opened by Senator Ignazio Zullo, leader of the Fdi group, the Commission for Social Affairs, Health, Public and Private Employment, Social Security of the Senate, engaged in the promotion of strategies for the prevention of chronic kidney disease, who reiterated the “role of the Institutions for the awareness of citizens and of health professionals themselves, with the aim of promoting the early identification of patients and the most appropriate therapeutic approach, so as to significantly reduce the need for dialysis and kidney transplantation”.
“The objectives of the work table – recalled Valeria Mastrilli, member of the ministerial technical table – are to know the state of implementation of the guidelines at the regional level, define interventions for the prevention of the disease and its evolution, identify further actions to guarantee Regions adequate assistance for patients affected by CKD, even in the course of a pandemic”. For Loreto Gesualdo, president of IMF, it is necessary to design a “preventive, diagnostic and assistance path for CKD applicable to all Italian regional realities and to fill thanks to the use of e-health platforms the current lack of hospital-territory integration and multidisciplinarity”.
“To reduce the number of cases of renal insufficiency – highlighted Gaetano Piccinocchi, member of the national Simg Committee – it is necessary to intervene on renal disease from its earliest stages, within a structured and shared path between different specialists (nephrologists , cardiologists, diabetologists, etc.) and general practitioners. It is therefore in the territory that an active intervention strategy must be born”. “There is a need for a revision of the healthcare organizational model – remarked Piergiorgio Messa, past president of Sin – which on the one hand reinforces the territorial network and on the other makes diagnostic, therapeutic, informative and organizational actions of nephrological activities possible, which conflicts with the numerical reduction of nephrologist specialists which risks compromising any programming “.
Antonio Santoro, scientific director of Aned, underlined the importance of primary prevention, placing the “need for an overall prevention strategy that includes a multisectoral intervention and an action on risk factors and determinants. In particular, he focuses on the adoption of strategies that aim to contrast modifiable risk factors and on early diagnosis, through the identification of those conditions that represent intermediate risk factors”.
Finally Giuseppe Quintaliani, communication manager of the Sin: “for effective prevention it is necessary to broaden the knowledge of chronic kidney disease and its correct diagnosis to 360°. For this purpose, it is necessary to implement various strategies which can include the classic way with press and TV in presence, but also to use social networks as a communication tool. The need to have trained human resources and communication experts emerges overwhelmingly, the only way to be able to enter this world and obtain significant advantages”.
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