Dalla medicina reattiva alla medicina di precisione

In recent years, there has been increased awareness of a concept of medicine based on individual differences taking into consideration genetic variability, environment, characteristics of the microbiome and individual lifestyles. It makes use of genomics, transcriptomics, proteomics and metabolomics techniques, obtaining a large amount of information which enables a more precise characterization of the patient. This model expands to the principles of prediction, prevention, personalization and participation, including all medical specialties. In nephrology, the application of precision medicine could play a central role, thanks to the information available today in multiple fields: for example the impact of alterations in the intestinal microbiota on the progression of chronic renal failure, in polycystic disease, in diabetic nephropathy and in the personalized approach to the transition period before the beginning of hemodialysis therapy.