There are about 60,000 dialysis patients in Germany, and 225,000 in Europe – and the number is rising! In 2002, the rate of new patients requiring dialysis was over 20%, at 14,358. There are many reasons for this rapid increase. The incidence of kidney disease is growing rapidly. The reasons lie on the one hand in demographic developments (the average age of the population is rising), and on the other hand in the explosive increase in common diseases that have a direct correlation with kidney disease, such as diabetes or high blood pressure.
Demographic developments
The rise in kidney disease leading to the need for dialysis will inevitably become a public health problem and will also place a heavy financial burden on the healthcare system. Already, around 10 billion euros are spent annually on the treatment of kidney disease in Europe alone. Catchwords such as “aging society” are striking, but they describe a fundamental problem in Western European countries.
The age pyramid will soon turn upside down, and due to low birth rates and increasing life expectancy, the average age is rising steadily in Germany as well. Kidney dysfunction and renal impairment are also symptoms of old age. The increasing aging of society is therefore one reason for the rising rate of kidney disease.
Interactions between kidney disease and “common diseases”
People with diabetes have an increased risk of developing renal insufficiency. Diabetes mellitus, especially type 2 (formerly “adult-onset” diabetes), is a widespread disease that is increasing rapidly. According to the German Diabetes Society, there are almost six million diabetics in Germany – and they form a large “risk group” for kidney disease. The correct adjustment of blood sugar, and even more importantly blood pressure, are fundamental preventive measures to counteract kidney disease as a result of diabetes.
High-pressure patients form a similar “risk group”. It can be assumed that more than half of Germany’s population suffers from high blood pressure, albeit mostly undiagnosed. Like diabetics, those affected have a higher risk of developing kidney disease.
Lack of preventive awareness
Another reason lies in the lack of preventive behavior: Regular preventive examinations are not taken up and, since kidney diseases run a “silent” course, patients often do not present themselves to the doctor until they have irreparably lost a large part of their kidney function. Screening could also be used more widely by primary care physicians, for example when patients present as part of the “annual checkup”. There is a need for improvement here, because kidney disease can be cured at an early stage, or at least its rapid progression can be halted, and does not inevitably lead to dialysis.
In addition to the risk of kidney failure, kidney damage also poses other dangers, as it can lead to serious illnesses. In turn, they trigger high blood pressure, can lead to heart disease such as heart attack and heart failure, anemia, and bone disease. The Society of Nephrology therefore advocates greater awareness of preventive care and aims to educate both the medical and non-medical public about the importance of early detection of kidney disease.
