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Original

Prevalence of chronic kidney disease and its risk factors among family practice patients in Lithuania

Inga Arūnė Bumblytė, Alanta Zilinskienė, Raymond Vanholder, Leonas Valius and Vytautas Kuzminskis

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Volume 78 (2012) p. 198 - 206

Abstract

Clinical Nephrology, Vol. 78 – No. 3/2012 (198-206)

Prevalence of chronic kidney disease and its risk factors among family practice patients in Lithuania

Inga Arūnė Bumblytė¹, Alanta Zilinskienė¹, Raymond Vanholder², Leonas Valius³ and Vytautas Kuzminskis¹

¹Department of Nephrology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania, ²Department of Nephrology, Ghent University, Ghent, Belgium, and ³Department of Family Medicine, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
Background: Early detection of chronic kidney disease (CKD) by the first line is essential. In many countries, serum creatinine measurements are reimbursed in home practice. In Lithuania however, until recently they were not. Therefore, the aim of this study was to assess the prevalence of risk factors of CKD in primary care patients, to evaluate the awareness of family practitioners and, finally, to investigate renal function parameters in patients at risk. Methods: We reviewed the charts of adult patients (n = 4,082) from four home practices in Kaunas and identified patients at increased risk for CKD (severe arterial hypertension, diabetes, cardiovascular disease (CVD), other causes of kidney damage). We noted age and gender in all patients, and renal function measurements performed over the preceding 24 months in the patients at risk. In the second part, we assessed nephrological status (history, clinical characteristics, serum creatinine, dipstick urinalysis and microalbuminuria, estimated glomerular filtration rate (eGFR) by the abbreviated MDRD formula) for those at risk who were referred by their family practitioners. Results: In total, 458 (11.2%) patients had risk factors for CKD. Severe arterial hypertension was found in 62.6% of these patients, diabetes in 20.9%, CVD in 6.2% and 34.5% had a history of kidney damage. Kidney tests had been performed by family practioner in 59% of these patients. Only 30.3% of these patients were referred to the nephrologist and an additional 20.1% came after receiving an invitation letter. eGFR < 60 ml/min/1.73 m2 was found in 42.9% of these patients, 23.4% had microalbuminuria and 7.8% overt proteinuria. Optimal blood pressure control (< 130/85 mmHg) was achieved in a minority (10.4%). 79.7% had abnormal BMI, 39% used no ACEI/ARB, and 16% were smokers. Kidney dysfunction was associated with a higher prevalence of microalbuminuria and a lower use of ACEI/ ARB. Conclusions: Risk factors for CKD were present in 11% of the patients in this primary care cohort. Kidney dysfunction was found in almost half of the patients at risk. However, awareness of this problem by family practitioners was low.Correspondence to:
Alanta Zilinskiene, MD
Hospital of Lithuanian
University of Health Sciences, Kauno klinikos
Department of Nephrology
Eiveniu 2, 50009, Kaunas, Lithuania
Email: [email protected]

Editorial

Kidney health for all: Caring for people, protecting the planet

Raymond Vanholder, Dina Abdellatif, Augusto Cesar Soares Dos Santos Jr., Ricardo Correa-Rotter, Natarajan Gopalakrishnan, Bill Wang, Stefanos Roumeliotis, Alessandro Balducci, Ágnes Haris, Manjusha Yadla, and Li-Li Hsiao

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Volume 106 (2026) p. 1 - 13

Abstract

Clinical Nephrology, Vol. 106 – No. 1/2026 (1-13)

Kidney health for all: Caring for people, protecting the planet

Raymond Vanholder¹#², Dina Abdellatif³, Augusto Cesar Soares Dos Santos Jr.⁴#⁵, Ricardo Correa-Rotter⁶, Natarajan Gopalakrishnan⁷, Bill Wang⁸, Stefanos Roumeliotis⁹, Alessandro Balducci¹⁰, Ágnes Haris¹¹, Manjusha Yadla¹², and Li-Li Hsiao¹³

¹Nephrology Section, Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, ²European Kidney Health Alliance, Brussels, Belgium, ³Department of Nephrology, Cairo University Hospital, Cairo, Egypt, ⁴Faculdade Ciencias Medicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil, ⁵Hospital das Clinicas, Ebserh, Universidade Federal de Minas Gerais, Minas Gerais, Brazil, ⁶Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico, ⁷Transplant Authority of Tamil Nadu, Chennai, India, ⁸Hong Kong Kidney Foundation, Hong Kong, SAR, China, ⁹²nd Department of Nephrology, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece, ¹⁰Italian Kidney Foundation Italy, Rome, Italy, ¹¹Department of Internal Medicine and Nephrology, Péterfy Hospital, Budapest, Hungary, ¹²Department of Nephrology, Gandhi Medical College, Hyderabad, Telangana, India; and ¹³Renal Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
The current kidney care model – focused on late-stage disease and in-center hemodialysis – is unsustainable, because of costs, environmental burden, poor outcomes, and reduced quality of life. The 78th World Health Assembly’s recognition of kidney disease as a serious health threat presents a critical opportunity to reshape kidney care. Aligned with this, the 2026 World Kidney Day theme, “Kidney Health for All: Caring for People, Protecting the Planet”, calls for a systematic change. A sustainable model must prioritize early detection and prevention, reducing the need for kidney replacement therapy. Transplantation and home dialysis benefit people with kidney failure, environment and society. Dialysis itself must become more eco-friendly without compromising care quality, recognizing that planetary perturbations in turn affect kidney health. Conservative care should also be considered, particularly for elderly and frail patients, if the quality-of-life benefits outweigh the perspectives offered by dialysis. Achieving this shift requires coordinated action across all stakeholders; education and engagement of the public, policy makers and health professionals to raise awareness about the threat of kidney disease; and an urgent move toward patient-centered care.Correspondence to:
Dr. Stefanos Roumeliotis, MD, PhD, FERA
Nephrologist, Fellow of the World Kidney Day Joint Steering Committee
2nd Department of Nephrology
AHEPA Hospital, Medical School
Aristotle University of Thessaloniki
1 St. Kyriakidi street
54636 Thessaloniki, Greece
Email: [email protected]

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