Kidney Disease

Deterioration in kidney function, whether acute or chronic, can lead to substantial morbidity and mortality. Acute kidney injury (AKI) is a powerful indicator for in-hospital mortality; those who survive face increased length and cost of hospitalization. Some individuals with chronic kidney disease (CKD) develop progressive renal dysfunction and require costly therapy with dialysis, transplant, or both. Even more often, individuals with CKD face high risks for cardiovascular events, anemia, and fractures. This chapter reviews current data on the epidemiology and trends in the etiology of AKI, CKD, and end-stage renal disease (ESRD), with a focus on lowand middleincome countries (LMICs). We also review management of these conditions, highlighting several interventions— treatment for AKI, screening for CKD, and modality choice for ESRD—with available data on cost or cost-effectiveness.