Early Diagnosis of CKD Is Inadequate for High Risk Patients

The majority of people with diabetes and/or high blood pressure--the two leading causes of chronic kidney disease (CKD)--are not receiving recommended tests to identify this disease early, when medical treatment can slow or halt disease progression. In addition many patients with early-stage CKD are not being well managed for contributing diseases, such as diabetes and hyperlipidemia.

A slightly elevated level of protein in the urine, or microalbuminuria, is one of the earliest markers of kidney disease. The microalbumin test can detect kidney damage when no other symptoms are present, and provides information that can help physicians and their patients determine treatment that can potentially slow disease progression.

A report was based on findings from 6.2 million estimated glomerular filtration rate (eGFR) test and microalbumin test results, the two key indicators of kidney function, performed by Quest Diagnostics Inc. (Lyndhurst, NJ, USA) between November 2005 and October 2006 on 5.2 million patients who saw a healthcare professional. Among patients who had an eGFR result, approximately 19% had a reading of < 60 ml/min/1.73 m, an indicator of kidney disease.

The study, which was conducted in the United States, suggested that there is a failure to implement evidence-based guidelines issued by the U.S. National Kidney Foundation (NKF; New York, NY, USA), American Diabetes Association (ADA; Alexandria, VA. USA), U.S. National Institutes of Health's National Kidney Disease Education Program (NKDEP; Bethesda, MD, USA), and U.S. National Heart, Lung, and Blood Institute (NHLBI; Bethesda MD, USA), which all recommend annual microalbumin testing to check and follow this marker of kidney damage among patients with hypertension, diabetes, cardiovascular disease (CVD), and other CKD risk factors.

"Physicians may believe that their patients are not at risk for chronic kidney disease if their blood glucose, lipids, and/or blood pressure are controlled. This is simply not true,” said Herman Hurwitz, M.D., FCAP, senior medical director, Quest Diagnostics. "Chronic kidney disease is an insidious consequence of these diseases and can progress quickly without routine monitoring. Patients at increased risk for chronic kidney disease should be screened for microalbuminuria at least annually, while those with confirmed microalbuminuria may require even more frequent monitoring depending on their response to treatment. Yet, our data suggest that at-risk chronic kidney disease patients are not being monitored as recommended by established guidelines.”


Related Links:
Quest Diagnosis
National Kidney Foundation
National Institutes of Health's National Kidney Disease Education Program