Résumé:
Chronic kidney disease (CKD) is a silent and poorly known killer The current concept of CKD is relatively young and uptake
by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney
insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In
Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually
need KRT and, for those in whom kidneys fail, the problem is ¿solved¿ by dialysis or kidney transplantation. However, KRT is
the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off
points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature
death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most
increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that
is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis
and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause
of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four
Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not
supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the
underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020¿2030 was
launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish
kidney researchers grouped in the kidney collaborative research network Red de Investigacio´n Renal have now applied for
the Redes de Investigacio´n Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain
with the support of the Spanish Society of Nephrology, Federacio´n Nacional de Asociaciones para la Lucha Contra las Enfermedades del Rino~ ´n and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from
becoming true.