How to prevent and manage Diabetic Kidney Disease in the Republic of Macedonia.

The Macedonian Society of Nephrology, Dialysis, Transplantation and Artificial Organs, the Macedonian Society of Nephrology and the Macedonian Society of Endocrinology and Metabolic Diseases and the general physicians held a one-day meeting on 11 March 2010 at the Macedonian Academy of Sciences and Arts devoted to the prevention and treatment of diabetic kidney disease. In the Republic of Macedonia there are about 100,000 patients with diabetes mellitus type 1 and 2; 85-95 % have diabetes mellitus type 2. On insulin therapy there are around 28,000-30,000 patients. In our papers: Chronic Kidney Disease: a Hidden Epidemic (2) and Public Health Aspects of Renal Disease in the Republic of Macedonia 1983-2007 (3) we have shown a continuous increase of end stage renal disease and renal replacement therapy (RRT) in the Republic of Macedonia. In 2002, we had 1,056 patients on RRT compared to 1,216 in 2005. In some dialysis centres 20% of the patients on haemodialysis are diabetics. Our message was that there is an urgent need for a screening programme for the detection of Chronic Kidney Disease (CKD) and we will suggest developing a strategy to check each patient in the Republic of Macedonia with diabetes mellitus, to detect early diabetic kidney disease by screening for albuminuria as well as for a reduced glomerular filtration rate. Health authorities, nephrologists and general physiccians should collaborate on the detection of CKD. In our country we should work harder on the prevention of diabetic kidney diseases, to stop or postpone the development of CKD and chronic renal failure with modern therapy and the need for RRT.