Chronic kidney disease: The complex history of the organization of long-term care and bioethics. why now, more than ever, action is needed

Abstract: Chronic kidney disease (CKD) has been redefined in the new millennium as any alteration of kidney morphology, function, blood, or urine composition lasting for at least 3 months. This broad definition also encompasses diseases or conditions that are associated with normal kidney function, such as a kidney scarring from an acute pyelonephritis episode or a single kidney, as a result of kidney donation. CKD is a relevant public health problem. According to the 2015 Global Burden of Disease Study, it was the 12th leading cause of death, leading to 1.1 million deaths, worldwide, each year. The role of CKD as a cause of death is evident where renal replacement therapy (RRT) is not available,however,itsroleinincreasingdeathriskisnoteasilycalculated. RRTconsumesabout3–5% of the global healthcare budget where dialysis is available without restrictions. While the prevalence of CKD is increasing overall as lifespans extend, being linked to diabetes, hypertension, obesity, and atherosclerosis,CKDisatleastpartlypreventableanditseffectsmaybeatleastpartlycounterbalanced byearlyandappropriatecare. WewillwelcomepapersonallaspectsofCKD,includingorganization, cost, and models of care. Papers from developing countries will be particularly welcomed.