3 articles
Chronic kidney disease (CKD) is a major and growing global public health problem, contributing to significant morbidity, mortality, and financial strain on healthcare systems. Despite available preventive measures, CKD often remains underdiagnosed and insufficiently addressed by health policies worldwide.
A literature review was conducted using the MEDLINE electronic database via PubMed, Scopus, and the HINARI (Research4Life) program, focusing on studies published since 2001. Search terms included “primary care”, “chronic kidney disease”, “chronic kidney disease public health”, and “chronic kidney disease costs”. Original articles, meta-analyses, and systematic reviews were included, with English-language articles prioritized. Bibliographic references of selected publications were also examined to identify additional relevant studies.
CKD affects approximately 700-850 million people globally, with rising prevalence and mortality rates, especially in low- and middle-income countries. The disease disproportionately burdens vulnerable populations and health systems due to high direct and indirect costs, particularly for advanced-stage care. While cost-effective prevention and early detection strategies are available, their implementation is uneven, and policy responses have historically lagged. Successful national initiatives demonstrate that early intervention and integrated care can reduce the incidence and economic impact of end-stage kidney disease.
CKD is a preventable, yet increasingly prevalent disease that requires urgent public health action. Prioritizing early detection, integrated care models, and policy reforms can significantly curb its global burden. Coordinated efforts at international, national, and local levels are essential to translate existing knowledge into effective practice and reduce the societal and financial costs of CKD.
Vitamin D plays an important role in maintaining musculoskeletal health. As the glomerular filtration rate decreases, vitamin D deficiency also occurs. The aim of this paper is to highlight the level of vitamin D depending on the stage of chronic kidney disease.
A structured search was performed in the PubMed, Scopus and HINARI databases, where the relevant articles have been taken into account, published in the last 20 years. The search terms used (in English) were: „vitamin D deficiency”, „pathogenesis of vitamin D”, ”the impact of vitamin D in chronic kidney disease”, „chronic kidney disease”.
Several studies have shown that the change in vitamin D levels is dependent to the decrease of glomerular filtration rate. The lowest serum vitamin D concentration was observed in stage 5 of chronic kidney disease. Vitamin D deficiency occurs due to a decrease in the number of nephrons and a decrease in the number of proximal tubular cells that absorb vitamin D (25 (OH) D) to be subsequently hydroxylated to its active form by 1α-hydroxylase.
Patients with vitamin D-deficient due to chronic kidney disease have an increased risk of decreased bone mineral density and multiple fractures.
Description of two clinical cases with gout and renal involvement, one male and one female, which were hospitalized in the „Timofei Mosneaga” Republican Clinical Hospital and Municipal Clinical Hospital „Saint Trinity” in 2021.
The male patient was hospitalized in a serious condition, being drowsy, disoriented and with bradyphrenia. Patient complained of dyspnea at mild exertion, severe fatigue, 5-day anuria and generalized edema. From the history collected from relatives, it was discovered that the patient has been diagnosed with gout a few years ago. The female patient has been hospitalized in the Nephrology department of the Republican Clinical Hospital „Timofei Moşneaga” for comprehensive evaluation. Her complaints: low back pain, dysuria, nocturia, moderate ankle edema, oliguria, marked asthenia, paresthesia.
In women, primary renal damage is more common until the onset of menopause. After the onset of menopause, there is primarily joint damage, then kidney damage, or this process develops simultaneously (kidney and joint damage). In males due to hyperuricemia, there is joint damage, which later is associated with gouty nephropathy or kidney and joint involvement evolve paralleled.