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Saturday 1st January, 2005
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The researchers analyzed data on nearly 20,000 U.S. adults by standard kidney function tests to determine whether they had CKD.
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Washington, DC (December 27, 2004)? Less than one-fourth of people
with test results showing chronic kidney disease (CKD) are aware
that they have any problem with their kidneys, reports the January
Journal of the American Society of Nephrology.
Awareness of CKD and reduced kidney function is particularly
low among women, according to a study by Dr. Josepf Coresh and colleagues
of Johns Hopkins Bloomberg School of Public Health, Baltimore.
The researchers analyzed data on nearly 20,000 U.S. adults participating
in nationwide health surveys in 1988-94 or 1999-2000. All underwent
standard kidney function tests to determine whether they had CKD?a
gradual, irreversible loss of kidney function, eventually leading
to end-stage renal disease (ESRD). Awareness of CKD was assessed
by asking the subjects whether a doctor had ever told them they
had "weak or failing kidneys."
Based on kidney function tests, approximately ten percent of
subjects had CKD. In contrast, only about two percent were aware
of any problem with their kidneys.
Awareness of CKD was low even for people with moderate to severe
reductions in kidney function. Just 24 percent of subjects with
Stage 4 CKD?the last stage before kidney failure?were aware they
had a kidney problem. For people with mild CKD?that requires treatment
to prevent further deterioration?the rate of awareness was just
one percent.
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Lack of awareness was a special problem in women. Just three
percent of women with moderate CKD were aware they had a kidney
problem, compared with 18 percent of men.
The overall rate of CKD remained stable from 1988-94 to 1999-2000,
suggesting that recent increases in ESRD cannot by explained by
rising rates of CKD. Instead, the rise in ESRD may be related to
more rapid progression of CKD and to reductions in other causes
of death, especially heart disease.
The rate of moderate to severe CKD was similar in African-American
subjects as in whites. This was surprising, because risk of ESRD
is about four times higher in African-Americans. Once established,
CKD may progress faster in African-Americans.
There is currently a worldwide epidemic of CKD, estimated to
affect one in nine individuals. The number of patients with CKD
who will require kidney dialysis or transplantation will double
in the next decade. However, studies suggest that CKD is often diagnosed
and untreated, even at the later stages when complications begin
to develop.
The new results confirm that most Americans with CKD?even severe
CKD?are not aware they have any problem with their kidneys. Women
are even less likely than men to be aware they have kidney disease,
perhaps reflecting problems with test interpretation.
Although the overall rate of CKD remains high, it has been stable
over the last decade and is similar for African-Americans and whites.
The researchers call for renewed efforts to increase awareness,
diagnosis, and treatment of CKD.
The ASN is a not-for-profit organization of 9,000 physicians
and scientists dedicated to the study of nephrology and committed
to providing a forum for the promulgation of information regarding
the latest research and clinical findings on kidney diseases.
Source:
American Society of Nephrology.
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