The holistic vision of the patient with chronic kidney disease in an universalistic health care system.

Chronic kidney disease (CKD)is an increasing public health problem.Aging is one of the leading causes, particularly in Western countries, but several comorbidities, such as hypertension and diabetes are involved in its pathogenesis. Thus, the treatment of CKDpatient is very complex and requires an integrated strategy. In this context, the holistic approach to the CKD patient and not to the disease itself should be the answer. General practitioners, specialists, voluntary associations, and non-profit organizations, in addition to the family of the patient, all contribute to the patient care. Moreover, due tothe low sensitivity of creatinine values in the early stages of renal failure, its diagnosis often occurs in the advanced phases of the disease. Therefore, the health costs for CKD patients are hardly sustainable by health systems. The reorganization of economic and epidemiological data through new models is necessary to allow the sustainability of the system and to ensure medical care for all patients. In this review, we aim to deal with all the issues aboutpatient care, standards of care, and the impact of chronicity from an global perspective in light of the current state of the Italian healthcare system. This article is protected by copyright. All rights reserved.