Do you know what it feels like to have a tremendous solution, one that can save lives, one that can make a difference to so many- and have to wait for the world to recognize the value of what you have?
I’ve had that feeling way more than a score of times in my life. Sure, when I was not even an adolescent, I could understand why the “old folks” (that was read as adults back then) wouldn’t take my word for it.
(About a year or two after I helped my uncle and dad get the National Haloid deal [I was almost 10 and now it was called Haloid Xerox], I convinced my dad that I could do his- and my uncle’s business- tax returns so much better than their expensive accountant. Yes, my uncle trusted me, so my dad did, too. I’ve been doing taxes that long!
Those were the only “adult” approved successes I had until I entered college. Of course, these adults were relatives- more trusting than strangers.)
Those kid of feelings – not that he wasn’t an adult, but the wonder why the world is missing the boat- have to have been churning in Dr. Navdeep Tangri’s brain, too. Way back in 2011, he developed (what he calls) an easy, reliable methodology to predict the likelihood (and severity) of a subject developing CKD, chronic kidney disease. (Yes, that often means they develop kidney failure.)
And, Tangri was a professor at the University of Manitoba (he’s now at Seven Oaks General Hospital in Winnipeg, Manitoba) and not a kid. Now, he just headed up a long-term study that proved the worth of this development. Regardless of the patient’s nationality or domicile, gender, age, general health status. (This study was performed because many folks felt his 2011 breakthrough idea would only apply to Canadians, since his data were developed from that population alone. It turns out that the US patient base matched the Canadians; only an adjustment was needed for non-North American patients, where the risk of kidney failure is lower.)
721,357 patients from 30 countries (on 4 continents) around the world [data from 1982 to 2014] were included in this study, published in the Journal of the American Medical Association. (In addition to Tangri, Drs. ME Grams, AS Levey, J Coresh, LJ Appel, BC Astor, G Chodick, AJ Collins, CR Elley, M Evans, AX Garg, SI Hallan, LA Inker, S Ito, SH Jee, CP Kovesky, F Kronenberg, JL Heerspink, A Marks, GN Nadkarni, SD Navaneethan, RG Nelso, S Titze, MJ Samak, D Stengel, M Woodward, K Iseki, as well as O Djurdjev were the authors of this multinational study.)
As is shown in the diagram above, the prediction uses just four patient variables- the protein concentration in their urine, age, gender, and GFR (glomerular filtration rate, a measure of how well their kidneys function) to come to their 5 year prognosis. Sure, the equation is a little simpler to use now, so that any physician worth her salt can use it. (This is critical because most patients are seen by family physicians- only the sickest 10%, or maybe 20%, visit nephrologists. We are talking about some 650K Americans, 3 million Canadians, and about another 650K folks worldwide that are at risk.)
How easy is the equation to us? Well, there’s a website that lets you use it. And, they’ve produced a smartphone app, too!
This should work out well for physicians and patients, both!
This is really cool—I just checked out the website. If more physicians use this method, think of all the preventative measures that could be taken early on to prevent kidney disease!
Absolutely true, Marcia.
And, just as important, think how relieved some folks may be to find- when they manifest the start of CKD that their likelihood of full blown failure is less likely- and can be further staved off with changes in diet, exercise, etc.
It is invaluable to have this type of research and option. A full 10% of our population has some form of kidney failure – it is a national epidemic. Identifying it sooner and taking the steps to reduce the long term damage are worthwhile endeavors.
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I’m not sure about the 10% number- that seems pretty darned high. But, given that diabetes and high blood pressure (themselves both linked) often leads to kidney failure, the potentiality is significant.
Thanks for the comment and the visit, mathea.
Very informative information. And you’ve been doing taxes since you were 10? Impressive!
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I consider taxes a sort of crossword puzzle, with a few wild card spots.
How to best position the data,to create a whole piece.
Thanks for the visit, Martha.
Roy – I am bookmarking this post; it is of great personal interest.
Glad to oblige, Alana!
I thought it was cool five years ago. Now, it should really become widely used.
A possible test for a dread disease? https://t.co/qsGynbUy2D via @Adjuvancy