The incidence of chronic kidney disease (CKD) and end-stage renal disease (ESRD) has been increasing steadily for decades. The CKD epidemic is a worldwide public health problem, associated with premature death, increased morbidity and, last but not least, enormous costs related to renal replacement therapy (RRT). The rise in ESRD globally is largely due to the increasing prevalence of diabetes mellitus and nephrosclerosis, the two major causes of CKD An increasing number of older patients, particularly those over 65 years of age, is also a contributing factor. CKD is usually associated with a progressive loss of renal function over several years or even decades. When patients with CKD progress to Stage 5 renal failure (glomerular filtration rate [GFR] below 15ml/min/1.73m2) they usually suffer from uraemic symptoms; at this stage the possibility of starting RRT should have already been discussed. There are two options for RRT: chronic dialysis therapy (peritoneal dialysis or haemodialysis) or renal transplantation (RTx). The present work relates primarily to kidney transplant patients.
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