Основные аспекты профилактики и подходы к лечению хронической болезни почек

Abstract

The pandemic of chronic non-communicable diseases, which claimed millions of lives each year, was a global challenge to modern health care worldwide, with not only medical but also great socio-economic significance, resulting in severe complications related to disability and the need for high treatment costs. Among them, kidney diseases occupy an important place due to the high prevalence, mortality, and sharp decline in the quality of life of patients. According to leading population registers (NHANTS III, Okinawa Stady), the prevalence of chronic kidney disease is at least 10%, reaching more than 20% in individual categories of individuals. Screening and identification of risk factors are inseparable from primary prevention of chronic kidney disease. Primary prevention is based on dispensary observation of patients of risk groups with subsequent development of individual medical recommendations for control of modified risk factors and control over their implementation. The use of innovative technologies of replacement renal therapy allows to achieve a higher degree of correction of anemia, nutritive status, social rehabilitation and quality of life of patients with terminal chronic renal failure. One promising direction is an integrated approach to replacement renal therapy, in which peritoneal dialysis is given the role of first-line therapy. The main activities for the provision of dialysis care for patients with chronic kidney disease are the development of a priority program for the provision of replacement renal therapy with a view to guaranteeing financial support, the development and implementation of a standard of dialysis care at the State level, the determination of a single cost of dialysis therapy, the application of tenders for the provision of medical services for dialysis, and support for the development of public and private dialysis centers.