Chronic kidney disease should become a priority area of russian healthcare. Statement by the Presidium of the Specialized Commission on Nephrology of the Ministry of Health of the Russian Federation

Chronic kidney disease (CKD) is the fifth globally socially significant chronic non–communicable disease recognized by WHO. The prevalence of CKD in the world ranges from 10 to 20 % and outstrips the prevalence of diabetes mellitus and cardiovascular diseases (850, 600, and 560 million people, respectively). By 2040, CKD will become the 5th cause of premature mortality, ahead of cancer and diabetes mellitus. In Russia, the prevalence of CKD in risk groups (hypertension, chronic heart failure, and diabetes mellitus) is at least 16 % of the country's population. CKD significantly increases the medical, social, and financial burden on the state budget, a significant part of which is spent on saving the lives of patients who have survived to the end stage renal disease, such as kidney replacement therapy (dialysis, kidney transplantation) and treatment of comorbid conditions. CKD makes a huge contribution to premature mortality. Most patients die from cardiovascular complications (strokes, heart attacks, heart failure) before the development of the terminal stage of the disease. Early detection of the disease will improve the ability to work and enhance the quality of life, as well as increase its duration. Special attention should be paid to risk groups, primarily patients with cardiovascular diseases and diabetes mellitus. The current management strategy for CKD patients is prevention and screening for early manifestations of CKD (decreased glomerular filtration rate and albuminuria), followed by the use of triple cardio–reno-protective therapy (RAAS inhibitors, glyphlozines, synthetic mineralocorticoid receptor blockers), which can slow the progression to the terminal stage of the disease and reduce mortality from cardiovascular complications. Preserving and prolonging the lives of CKD patients requires appropriate government organizational measures – in essence, changing the existing healthcare model focused on the terminal stages of the disease to a model aimed at prevention, early detection, and slowing the progression of CKD

1. Kidney disease: a global health priority. Nature Reviews Nephrology 2024;20:421–423. doi: 10.1038/s41581-024-00829-x

2. Kobalava ZhD, Villevalde SV, Bagmanova NKh et al. The prevalence of chronic kidney disease markers in arterial hypertension patients and relation with diabetes: results of epidemiological study KHRONOGRAPH. Russian Journal of Cardiology 2018;(2):91–101. (In Russ.) https://doi.org/10.15829/1560-4071-2018-2-91-101

3. Шляхто ЕВ, Беленков ЮН, Бойцов СА и др. Результаты промежуточного анализа проспективного наблюдательного многоцентрового регистрового исследования пациентов с хронической сердечной недостаточностью в Российской Федерации «ПРИОРИТЕТ-ХСН»: исходные характеристики и лечение первых включенных пациентов. Российский кардиологический журнал 2023;28(10):5593. doi:10.15829/1560-4071-2023-5593 Shlyakhto EV, Belenkov YuN, Boytsov SA et al. Interim analysis of a prospective observational multicenter registry study of patients with chronic heart failure in the Russian Federation "PRIORITETCHF": initial characteristics and treatment of the first included patients. Russian Journal of Cardiology 2023;28(10):5593. (In Russ.) doi: 10.15829/1560-4071-2023-5593. EDN: AMDHTV

4. https://rosstat.gov.ru

5. Yagudina RI, Kulikov AYU, Serpik VG, Abdrashitova GT. The economic burden of chronic kidney disease in the Russian Federation. Pharmacoeconomics: Theory and Practice 2014; 2(4): 34–39

6. Shilov EM, Shilova MM, Rumyantseva EI and others. Nephrological Service of the Russian Federation 2024: Part I. Renal replacement therapy. Clinical nephrology 2025;(1):6–17. doi: 10.18565/nephrology.2025.1.6-17

7. Boenink R, Bonthuis M, Boerstra BA et al. The ERA Registry Annual Report 2022: Epidemiology of Kidney Replacement Therapy in Europe, with a focus on sex comparisons. Clin Kidney J 2024 Dec 12;18(2):sfae405. doi: 10.1093/ckj/sfae405. Erratum in: Clin Kidney J. 2025 May 05;18(5):sfaf107. doi: 10.1093/ckj/sfaf107. PMID: 40008269; PMCID: PMC11852260

8. Stel VS, Boenink R, Astley ME et al. A comparison of the epidemiology of kidney replacement therapy between Europe and the United States: 2021 data of the ERA Registry and the USRDS. Nephrol Dial Transplant 2024 Sep 27;39(10):1593–1603. doi: 10.1093/ndt/gfae040