Early Detection Aims to Reverse Rising Rate of Kidney Disease

(New York, NY) — The old adage "an ounce of prevention is worth a pound of cure" will take on new meaning this March as kidney experts make plans to help ensure that people at risk don't end up with kidney failure or dying an early death due to complications of the disease. Those with kidney failure require dialysis treatment or a kidney transplant in order to stay alive.

Led by kidney specialists Dr. Andrew S. Levey at Tufts Medical Center in Boston, MA, and Dr. William McClellan at Emory University in Atlanta, GA, the panel of experts designed a comprehensive public health strategy to prevent the development and complications of chronic kidney disease in the U.S.

Commissioned by the U.S. Centers for Disease Control and Prevention (CDC), their report is published in the March issue of the American Journal of Kidney Diseases, the official journal of the National Kidney Foundation, scheduled to coincide with National Kidney Month (March) and World Kidney Day on March 12.

The treachery of chronic kidney disease, which currently affects 26 million Americans, is its silent progression in the early stages when it is most treatable. If left unchecked, the most deadly form of the disease - kidney failure - occurs when the kidneys can no longer function to filter out the body's waste products. Kidney failure is expected to affect a growing number of patients over the next decade, devouring an increasing fraction of available health care dollars.

But according to the authors, the ravages of kidney failure, also known as end stage kidney disease, can be held at bay by preventing the disease to begin with, detecting it in its earliest stages and providing treatment.

Their plan begins by targeting people who may not yet have kidney disease but are at risk, either because of their advancing age, a family history of the condition, or the presence of conditions that damage the kidneys, such as high blood pressure, diabetes, or cardiovascular disease.

The authors propose concrete measures to reduce this public health threat, such as:

* Raising awareness of the danger among those at risk
* Routine testing to detect the condition in its earliest stages, with a urine test to detect albumin and a blood test for creatinine to estimate the glomerular filtration rate (a measure of how well the kidneys are functioning)
* Reducing risk by improving blood pressure control among those with hypertension
* Reducing risk by improving blood sugar control among those with diabetes

"Equally as important is preventing progression in patients who already have chronic kidney disease," said Dr. Levey, who is a member of the National Kidney Foundation's Scientific Advisory Board. "One important measure is treating hypertension with drugs called ACE inhibitors and angiotensin-receptor blockers (ARBs) that protect the kidneys while keeping blood pressure in check."

For patients with more advanced stages of chronic kidney disease, and those with kidney failure, the panel urges continuing education for health care providers as to best treatment practices. Proper interventions for complications of reduced kidney function, such as anemia, malnutrition, and bone and mineral disorders, are necessary to prolong survival, enhance quality of life, and reduce the cost of care.

"While all the proposed measures are important, as a physician, I stress routine testing of patients at increased risk for chronic kidney disease," Dr. Levey said. "Given the high prevalence of hypertension and diabetes in the elderly, this would include testing most older individuals with a chronic medical condition."

"Routine reporting of glomerular filtration rate estimates by clinical laboratories whenever serum creatinine is measured has been a big help, and should receive continued emphasis," adds Dr. Kerry Willis, Senior VP for Scientific Activities, National Kidney Foundation.

Of paramount importance to the success of this initiative, the specialists say, is their final recommendation to increase public awareness of chronic kidney disease in order to improve health-related decisionecommendation to increase public awareness of chronic kidney disease in order to improve health-related decision-making.

In order to enact these recommendations, "Cooperation among federal, state and local governmental and private organizations will be necessary," noted Dr. Levey.

As a first step towards increasing public awareness of and making early detection as easy as possible, the National Kidney Foundation is offering 50 free screenings in locations around the U.S. on World Kidney Day, March 12 through the Kidney Early Evaluation Program (KEEP). KEEP is offered to those at risk -anyone with diabetes, high blood pressure or a family history- with the goal of preventing kidney disease from becoming kidney failure. For locations and schedules, visit www.keeponline.org.

The National Kidney Foundation is dedicated to preventing and treating kidney and urinary tract diseases, improving the health and well being of individuals and families affected by these diseases, and increasing availability of all organs for transplantation.

Source : http://www.medscape.com/viewarticle/590780?src=mp&spon=34&uac=133298AG