In Italy, 2.5 million people suffer from kidney diseases. These diseases represent a wide range of diseases with the common characteristic of causing a reduction in renal function (renal failure). The reduction of renal function may evolve to terminal renal failure, a situation that requires transplantation or the onset of dialysis. In Italy, 50,000 patients currently undergo dialysis therapy: this is a minimum portion of the population (less than one thousandth), but 2% of the resources allocated to health care are affected. We talked about it with Dr. Alberto Saita, endocrinologist at Humanitas and with Dr. Salvatore Badalamenti, nephrologist at Humanitas.
Kidney failure, the role of active prevention
Active prevention plays a decisive role in effectively and sustainably combating an increasingly common disease such as kidney failure. Promoting correct lifestyles and early diagnosis is not enough, as this is an established pathology; it is essential to actively intervene to slow down its course. Nutritional Dietary Therapy (NDT) has been shown to delay the progression of chronic renal failure and the pathologies that coexist simultaneously but independently of it, reducing the risk of escalation towards the dialysis phase, with a significant improvement in the quality of life of patients. “Today the nephrologist has to work more and more on the prevention front, in particular in diabetic, hypertensive and elderly patients, who more than others run the risk of suffering from kidney failure,” says Giuliano Brunori, president of the Italian Society of Nephrology. Prevention is carried out by undergoing the necessary controls, blood and urine tests to detect any markers of kidney damage, as well as adopting a healthy lifestHul activity and, for those who suffer, keeping under control diabetes and hypertension.
The two options: transplantation and dialysis
“When renal function is definitively compromised – continues Brunori – there are two options: transplantation and dialysis. Transplantation, however, is for a few, so much so that today only 6,000 patients are on the waiting list for a kidney. Dialysis can be practiced in two ways: hemodialysis, which is the classic hospital therapy that provides 3 sessions per week lasting about 4 hours, which has a major impact on the quality of life, or peritoneal therapy at home, which is advantageous because it allows better management of daily activities. But only 5,000 patients practice it compared to 45,000 who do hemodialysis. Overall, the 50,000 Italian dialysis patients cost the health system about 2.5 billion euros each year, a sum that corresponds to 2% of the expenditure. This means that just under 0.1% of the population consumes an enormous amount of resources allocated to health care. In the light of these data, investing in prevention is therefore crucial, also from the point of view of the sustainability of the expenditure”.