Clinical and experimental nephrology
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The prevalence of end-stage renal disease (ESRD) is rising throughout the developed and developing world, although the rate of increase may be attenuating in some regions. Type 2 diabetes mellitus, often a consequence of obesity and accompanied by the metabolic syndrome, is a major cause of progressive renal disease and the increasing global burden of ESRD. ⋯ Primary and secondary prevention measures, involving screening and interventions, have demonstrated beneficial effects when appropriately designed and targeted to "high-risk" groups. If these strategies can be implemented at the societal level and compliance with the interventions is robust, it is entirely possible that the rising tide of ESRD can be converted into a receding tide of ESRD in the future.