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 mix up 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 aging 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 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 which is 10- o 100-fold higher than similar age peers, and life expectancy is shortened by around 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 global cause of death by 2040 and the second cause of death in Spain before the end of the century, a time when 1 in 4 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 CIBER network research 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 (AAKP) and the European Kidney Health Alliance (EKHA). Leading Spanish kidney researchers grouped in the kidney collaborative research network REDINREN have now applied for the RICORS call of collaborative research in Spain with the support of the Spanish Society of Nephrology, ALCER and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true.

An outbreak of Legionnaire's disease was detected in Pamplona, Spain, on 1 June 2006. Patients with pneumonia were tested to detect Legionella pneumophila antigen in urine (Binax Now; Binax Inc., Scarborough, ME, USA), and all 146 confirmed cases were interviewed. The outbreak was related to district 2 (22 012 inhabitants), where 45% of the cases lived and 50% had visited; 5% lived in neighbouring districts. The highest incidence was found in the resident population of district 2 (3/1000 inhabitants), section 2 (14/1000). All 31 cooling towers of district 2 were analysed. L. pneumophila antigen (Binax Now) was detected in four towers, which were closed on 2 June. Only the strain isolated in a tower situated in section 2 of district 2 matched all five clinical isolates, as assessed by mAb and two genotyping methods, AFLP and PFGE. Eight days after closing the towers, new cases ceased appearing. Early detection and rapid coordinated medical and environmental actions permitted immediate control of the outbreak and probably contributed to the null case fatality.

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The epidemiological situation of HIV infection and AIDS in Navarre in 2003 is reviewed. Up until December 2003, 1,610 HIV infections had been diagnosed in residents of Navarre, of whom 41% had died. The new diagnoses of HIV fell by some 81% between 1993 and 2003, a year in which 28 cases were diagnosed (4.8 per 100,000 inhabitants). The fall basically occurred in infections in injection drug users, since the cases due to sexual transmission had remained stable. Over half of the infections diagnosed in the period 2000-2003 (58%) were attributable to heterosexual transmission, 18% occurred in parenteral drug users and 12% in homosexual men. Thirty-three percent were persons originally from other countries. The incidence of AIDS fell from 75 cases in 1996 to 20 in 2003, and mortality from 65 to 8 cases, respectively. In the 2000-2003 period, the average annual incidence of AIDS was 4.2 per 100,000 inhabitants and the average annual rate of mortality was 1.6 per 100,000 inhabitants. At the end of 2003, there were 902 living persons with a diagnosis of HIV monitored by the health system (1.6 known infections per 1,000 inhabitants). In 2003, 65% of the youths aged between 15 and 29 referred to coital sexual relations, a higher percentage than in previous years, but their level of information on the prevention of AIDS was acceptable. It is necessary to insist on prevention and to adapt this to the new situation.