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4.1 Pre-Dialysis - Retarding Progression and Reducing the Comorbid Burden in Renal Disease 4.1.4 Overlap with the National Service Framework for Coronary Heart Disease (CHD) (ref.63) The recent launch of the NSF for CHD has broader aims than reducing the burden of heart disease and it is hoped that the incidence of other cardiovascular diseases (especially stroke) will be reduced. It is also hoped that the initiative will encourage systematic approaches which can be applied to other clinical areas. They include the development of registers for chronic diseases and local protocols for referral and treatment. One of the 12 standards in the CHD NSF covers the reduction of risk factors in the population. Given the recognised deleterious effect of smoking, hyperlipidaemia and poorly controlled hypertension in progressive renal disease it would not be unreasonable to expect that significant successes in these areas may well produce a favourable effect on the incidence of ESRF.  |