Few Americans aware they have chronic kidney disease

December 16, 2004

Ten to 20 million people in the United States have chronic kidney disease but most don't know it, according to a study by researchers at the Johns Hopkins Bloomberg School of Public Health, the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health and the National Center for Health Statistics. The findings are published in the January 2005 print editions of the Journal of the American Society of Nephrology and on the journal's website.

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 Josef 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. Data were from two National Health and Nutrition Examination Surveys by NCHS of nationally representative, non-institutionalized adults.

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 Thomas 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. 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 www.nkdep.nih.gov.

"Chronic Kidney Disease Awareness, Prevalence and Trends among U.S. Adults, 1999 to 2000" was written by Josef Coresh, Danita Byrd-Holt, Brad C. Astor, Josephine P. Briggs, Paul W. Eggers, David A. Lacher and Thomas H. Hostetter and appears in the Journal of the American Society of Nephrology.

Funding for the study was provided by the National Center for Research Resources and the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health, and by the American Heart Association Established Investigators Award.

Johns Hopkins University Bloomberg School of Public Health

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.