Study: kidney damage increasing, patients remain unaware

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Monday, November 12, 2007

Schematic illustration of a kidney. The kidneys filter wastes from the blood and are involved in the regularization of blood pressure, red blood cell count and bone mineralisation.

New research based on data gathered on approximately 28,000 individuals over a 16-year period indicates that even as more people in the U.S. are acquiring chronic kidney disease, the vast majority of those who are in the early and middle stages of its progression -- when it is most treatable -- have no idea their kidneys are weak or damaged until failure is imminent.

Only 42 percent of study subjects who had Stage 4 kidney disease were aware of it, according to an analysis of data from two National Health and Nutrition Examination Surveys, conducted by researchers at Johns Hopkins University in Baltimore, Tufts-New England Medical Center in Boston and Cleveland Clinic Foundation, and published in the Journal of the American Medical Association.

The percentage of people with stage 1 through 4 disease increased from 10.0% in the period 1988-1994 to 13.1% in 1999-2004, mostly due to an increase in diabetes and high blood pressure rates. Stage 5 is kidney failure, when dialysis or organ transplant are the only options.

Screening of persons at risk -- those with diabetes, high blood pressure or a family history of kidney problems -- is of utmost importance, said Andrew S. Narva, MD, FACP, director of the NIH's National Kidney Disease Education Program.

Much can be done to prevent kidney failure if the disease is caught early enough. For example, careful attention to monitoring blood glucose levels, keeping blood pressure under control, and certain prescription medications can be beneficial, according to the NKDEP. Unfortunately, the most commonly performed blood test to look at kidney function, the creatinine level, has limited precision and needs to be interpreted carefully.

The 13 percent estimate means that some 26 million Americans are thought to have kidney disease, and since risk factors like high blood pressure and diabetes are still increasing, the study raises concerns about future trends of chronic kidney disease and complications. People with kidney disease are at greater risk of hypertension, heart attacks and strokes. They are also more vulnerable to anemia, bone disease and malnutrition.

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