CKD Awareness

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Few Americans Aware They Have Chronic Kidney Disease

Date: Tuesday, December 21 @ 12:27:05 EST

Topic: DIC Newsletter Issue 239

Less than 10 percent of adults with moderately decreased kidney function

reported being told they had weakened or failing kidneys.

Ten to 20 million people in the United States have chronic kidney

disease but most don't know it.

Over the past decade the number of people with kidney failure doubled

and the number starting dialysis or having a first kidney transplant

increased by 50 percent, so that more than 400,000 Americans are now

being treated for kidney failure at a cost of $25 billion annually. In

contrast to these dramatic increases, the study found that the number of

people with earlier stages of kidney disease remained stable, with 7.4

million people having less than half the kidney function of a healthy

young adult and another 11.3 million consistently having protein in

their urine. The researchers can't explain this paradox, but suggest

that fewer patients may be dying and more may be progressing to dialysis

faster.

" Given the high prevalence of chronic kidney disease, we need to

increase awareness, diagnosis and treatment if we are going to reduce

the rate of progression and complications. Most critical are control of

diabetes and hypertension. " said f Coresh, MD, PhD, lead author of

the study and professor of epidemiology, medicine and biostatistics at

the Bloomberg School of

Public Health.

Dr. Coresh and his colleagues estimated awareness of chronic kidney

disease among 4,101 people in the United States from 1999 to 2000 and

compared disease prevalence in those years with that from 1988 to 1994,

when 15,488 people were surveyed.

In the recent survey participants were asked: " Have you ever been told

by a doctor or other health professional that you had weak or failing

kidneys (excluding kidney stones, bladder infections, or incontinence)? "

Less than 10 percent of adults with moderately decreased kidney function

(one half to one quarter the filtering capacity of a young healthy

adult) reported being told they had weakened or failing kidneys.

Awareness was low in all but the most severe stages of kidney disease.

Women with moderately decreased kidney function were significantly less

aware of their illness compared to similarly affected men.

Lack of awareness may be due in part to most doctors' sole reliance on a

test that measures the blood level of a substance called creatinine.

Unfortunately, the test is affected by muscle mass and other

person-to-person variables. " Most blood tests include creatinine, but

the numbers can be misleading. Kidney disease can be quite advanced

before it's found this way. " said H. Hostetter, MD, senior study

author and director of NIDDK's National Kidney Disease Education Program

(NKDEP). NKDEP recommends that doctors take creatinine a simple step

further to estimate glomerular filtration rate (GFR). GFR is a more

accurate gauge of how well the kidneys are working.

" We can use a patient's creatinine number, age, gender and race to

estimate GFR and find kidney disease earlier, when there's still time to

treat it. A free GFR calculator makes estimating a snap. " said Dr.

Hostetter (See this weeks Tool For Your Practice) NKDEP is also working

to make the task even easier for busy physicians. " We are very pleased

that several major labs have agreed to automatically report GFR whenever

creatinine is measured. We are still working quite hard to standardize

tests for kidney disease by all labs. "

People with chronic kidney disease are at high risk for premature death,

heart attacks and strokes as well as hypertension, anemia, bone disease

and malnutrition. NKDEP strives to increase awareness about kidney

disease and offers the GFR calculator and other free tools at

http://www.nkdep.nih.gov.

Finding published in Journal of the American Society of Nephrology

January 2005 and on the journal's website.

cappie

Greater Boston Area

T-2 10/02 9/04 A1c: 5.3

max 100 carb diet, walking, Metformin.

ALA/EPO, Coq10, B12, ALC, Vit C

Cal/mag, low dose Biotin, full spectrum E,

Policosanol, fish oil cap,

fresh flax seed, multi vitamin,

Lovastatin 20 mg, Enalapril 10 mg

12/04:143 lbs (highest weight 309),

5' tall /age 66,

cappie@...