It’s Kidney Week. OK. It’s kidney 5 days… Starting today and ending on the 10th. A ‘week’ to make all of us more aware of one of our biggest killers- certainly one of our most expensive diseases- that is, often, undetected. Why is that so? Because most subjects (they are not yet patients) exhibit no symptoms, until a crisis has developed.
If you have hypertension, you are at risk for kidney disease. If you have diabetes, you are risk for kidney disease. Given our obesity situation, it should not be surprising that chronic kidney disease (CKD) is on the rise.
CKD is defined as a condition where a person manifests decreased kidney function for at least three months. How prevalent is that? More than 1/3 those suffering diabetes over the age of 20 also have CKD. More than 1/5 of those with hypertension suffer from CKD. That means some 26 million in the US, alone.
I’ve mentioned often that this disease is one of the single biggest expenses with which Medicare is involved. $ 41 billion- this year- and that cost is climbing! Dialysis is a big component of that cost.
This is one of the reasons why the National Kidney Foundation (NKF) updated their guidelines this past August to include an annual kidney disease screening test for all those over the age of 60- whether or not they have the associated diseases above. Because if we catch CKD early, we can stop it or, even, possibly reverse it; yet once it is in advanced stages, the condition is irreversible.
But, not everyone agrees with the NKF. The American Society of Nephrology (which holds its annual meeting this week) thinks all adults need screening. The American College of Physicians is against screening, unless the subject manifests other risk factors (diabetes and hypertension are among them).
The good thing is that the two screening tests are both simple and cheap (if done in conjunction with an annual exam). Serum albumin (a blood protein) should be below 3 mg/dL (we used to call this 30 mg%). The other test measures creatinine (which is an indicator of kidney function, in particular-the Glomerular Filtration Rate [GFR], a parameter that should be greater than 60 mL/min); the creatinine level should be well below 10 mg/dL.
Given our lifestyles and longevity, about 60% of Americans can expect to suffer moderate CKD within their lifetime. Blacks will have a higher propensity than Whites, which is more related to the prevalence of the associated diseases listed above.
I have also mentioned that there is a potential protocol (it’s not really a drug regimen) that could reduce these rates. These facts remind me that I have to stop saying I’m too busy to take the time to bring it to market.
