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Chronic kidney disease rises while most people with the condition remain unaware
November 12, 2007A growing number of Americans have chronic kidney disease, but most remain unaware of it, hampering efforts to prevent irreversible kidney failure requiring dialysis or a transplant, according to a study funded by the National Institutes of Health and published November 7 in the Journal of the American Medical Association.
An estimated 26 million people - about 13 percent of the U.S. population - now have chronic kidney disease, say researchers at Johns Hopkins University in Baltimore, Tufts-New England Medical Center in Boston and Cleveland Clinic Foundation. This new report raises by 3 percent the previous estimate of 20 million people with the disease in 1994.
"Increases in diabetes, hypertension, obesity, and the aging U.S. population explain at least some of the increase," says co-author Paul W. Eggers, Ph.D., director of kidney disease epidemiology at the National Institute of Diabetes and Digestive and Kidney Diseases, part of the NIH. "We don't know what may be responsible for the rest."
The study analyzed and compared National Health and Nutrition Examination Survey data on adults age 20 or older from 1988 to 1994 and 1999 to 2004. More than 15,000 and 13,000 adults, respectively, were interviewed at home and had a physical exam and blood and urine tests. The surveys were conducted by the National Center for Health Statistics, part of the Centers for Disease Control and Prevention.
Kidney function was estimated for each participant with a formula that considers the amount of creatinine in a blood sample, along with age, gender and African American race, which can affect results. Creatinine is a waste product created by normal breakdown of muscle cells during activity. When kidneys are ailing, creatinine builds up in the blood. A small sample of urine was checked for a protein called albumin. Damaged kidneys may persistently leak albumin from the blood into the urine, sometimes even when kidney function appears normal.
Awareness of chronic kidney disease is up, but most people who have the condition still don't know it. Between 1999 and 2004, survey participants were asked if they had been told they had "weak or failing kidneys." The authors report that only 11.6 percent of men and 5.5 percent of women with moderate (stage 3) kidney disease knew it. Awareness increased to 22.8 percent among participants with stage 3 disease and albumin in the urine. Awareness was highest among people with severe (stage 4) kidney disease, only 42 percent of whom knew they had the condition. Stage 5 is kidney failure.
"Kidney disease is often silent until late stages, but if we can find it early we can do a lot to prevent kidney failure," explained Andrew S. Narva, M.D., F.A.C.P., a kidney specialist at the NIH. "If you have diabetes, high blood pressure or a family history of kidney problems you are at risk and should be screened for kidney damage with routine blood and urine tests."
"To help protect the kidneys' small blood vessels, carefully control high blood pressure, and blood sugar if you're diabetic, and ask your doctor if you should take an angiotensin converting enzyme inhibitor or angiotensin receptor blocker," advised Narva, also director of the NIH's National Kidney Disease Education Program.
NIH/National Institute of Diabetes and Digestive and Kidney Diseases
The study analyzed and compared National Health and Nutrition Examination Survey data on adults age 20 or older from 1988 to 1994 and 1999 to 2004. More than 15,000 and 13,000 adults, respectively, were interviewed at home and had a physical exam and blood and urine tests. The surveys were conducted by the National Center for Health Statistics, part of the Centers for Disease Control and Prevention.
Kidney function was estimated for each participant with a formula that considers the amount of creatinine in a blood sample, along with age, gender and African American race, which can affect results. Creatinine is a waste product created by normal breakdown of muscle cells during activity. When kidneys are ailing, creatinine builds up in the blood. A small sample of urine was checked for a protein called albumin. Damaged kidneys may persistently leak albumin from the blood into the urine, sometimes even when kidney function appears normal.
Awareness of chronic kidney disease is up, but most people who have the condition still don't know it. Between 1999 and 2004, survey participants were asked if they had been told they had "weak or failing kidneys." The authors report that only 11.6 percent of men and 5.5 percent of women with moderate (stage 3) kidney disease knew it. Awareness increased to 22.8 percent among participants with stage 3 disease and albumin in the urine. Awareness was highest among people with severe (stage 4) kidney disease, only 42 percent of whom knew they had the condition. Stage 5 is kidney failure.
"Kidney disease is often silent until late stages, but if we can find it early we can do a lot to prevent kidney failure," explained Andrew S. Narva, M.D., F.A.C.P., a kidney specialist at the NIH. "If you have diabetes, high blood pressure or a family history of kidney problems you are at risk and should be screened for kidney damage with routine blood and urine tests."
"To help protect the kidneys' small blood vessels, carefully control high blood pressure, and blood sugar if you're diabetic, and ask your doctor if you should take an angiotensin converting enzyme inhibitor or angiotensin receptor blocker," advised Narva, also director of the NIH's National Kidney Disease Education Program.
NIH/National Institute of Diabetes and Digestive and Kidney Diseases
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Researchers at the University of Maryland School of Medicine have made an important discovery about why potassium builds up to dangerous levels in the bloodstream, a relatively common medical problem that affects about eight percent of hospitalized patients.
Reduction in glycotoxins from heat-processing of foods reduces risk of chronic disease
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Help your kidneys: Pass on salt and diet soda
Individuals who consume a diet high in sodium or artificially sweetened drinks are more likely to experience a decline in kidney function, according to two papers being presented at the American Society of Nephrology's annual meeting in San Diego, California.
Can charcoal fight heart disease in kidney patients?
Charcoal may provide a new approach to managing the high rate of heart disease in patients with advanced kidney disease, according to preliminary research being presented at the American Society of Nephrology's 42nd Annual Meeting and Scientific Exposition in San Diego, CA.
Women with chronic kidney disease more likely than men to go undiagnosed
Woman are at particular risk of their primary care physicians delaying diagnosis of chronic kidney disease (CKD), according to a paper being presented at the American Society of Nephrology's 42nd Annual Meeting and Scientific Exposition in San Diego, California.
For dialysis patients, skinny is dangerous
Dialysis patients with low body fat are at increased risk of death-even compared to patients at the highest level of body fat percentage, according to research being presented at the American Society of Nephrology's 42nd Annual Meeting and Scientific Exposition in San Diego.
Protein critical for insulin secretion may be contributor to diabetes
A cellular protein from a family involved in several human diseases is crucial for the proper production and release of insulin, new research has found, suggesting that the protein might play a role in diabetes.
Learning the risks for stroke - and taking action
With this theme in mind, the European Society of Cardiology (ESC) emphasises that most of the risks for stroke are also the major risks for coronary heart disease - and thus the object of the ESC's far-reaching prevention programme.
American Dietetic Association supports IOM recommendations on school meal programs
The American Dietetic Association welcomes a report issued Wednesday, October 21, by the Institute of Medicine encouraging federal school meal programs to adopt standards that increase the nutrition content and limit the calories in meals served to schoolchildren.
Cost Effectiveness of Blood Pressure Device Evaluated
A study conducted by the University of Rochester Medical Center (URMC) demonstrates that, for certain patient populations, an experimental device that lowers blood pressure may be a cost effective treatment. The implantable device, called Rheos, is in advanced stages of testing for individuals with drug resistant hypertension.
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