Slowing the Progression of Chronic Renal Parenchymal Disease
End-stage renal failure (ESRF) is a major cause of morbidity and mortality in North America as well as in the rest of the world. In addition, the treatment of patients who have ESRF is quite expensive. It is estimated that for an in-hospital hemodialysis patient, the average annual cost is approximately $54,000 in Canadian dollars and a peritoneal dialysis patient's annual care costs approximately $32,000 in Canadian dollars, whereas a kidney transplant patient costs about $25,000 dollars a year in Canadian dollars. And as renal replacement therapy by hemodialysis, periltoneal dialysis or successful kidney transplantation prolongs survival in ESRF patients, new dialysis patients have been outnumbering those who die from ESRF. To complicate matters further, the number of ESRF patients have been on the rise the last two decades and is expected to continue to rise at a rate of about 6 to 10% per year through the next one to two decades, putting more strain on the national economy, human resources and on an already strained health care system.
Therefore, it makes sense to slow down or delay the progression of chronic renal parenchymal disease, or when possible, to prevent it from happening altogether. In this article, we will review the mechanisms and course of progression of renal injury and elaborate on the currently recommended strategies to delay or halt the progression of chronic renal disease.
LicenseAuthors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).