The National Kidney Foundation has released new guidelines that encourage earlier screening for kidney disease. This is the result of two years of study of published data demonstrating that the number of Americans with kidney failure is rising dramatically and that diagnosing chronic kidney disease earlier allows for more effective treatment. By their estimates, 20 million people in the U.S. have the disease and another 20 million are at increased risk for it.

The guidelines identify five stages of kidney disease, increasing in severity. It is this broader definition of kidney disease that will make the difference. Until now, only those with kidney failure, which requires expensive therapies like dialysis or kidney transplant to keep the patient alive, were classified as having kidney disease. But with increased awareness of the early signs of decline in kidney function, patients can be diagnosed sooner and treatment can be initiated earlier to prevent or delay the progression to more severe kidney disease.

However, this is complicated by that fact that a person with early kidney disease may not experience any symptoms. For this reason, laboratory tests are critical. The guidelines urge all people with diabetes, high blood pressure, or a family history of kidney disease as well as older Americans, Americans of African descent, Hispanics, Asians, and Pacific Islanders to ask their doctor for three simple tests that can be performed during a regular physical exam in order to screen for kidney disease:

• a blood pressure check;
• a blood test for creatinine and, with that, an estimation of the glomerular filtration rate (EGFR), which indicates the rate at which waste is being filtered by the kidneys; and
• a urine test (urinalysis or microalbumin) to look for unusually large amounts of protein being excreted.

Results from these tests will allow medical providers to intervene early if a patient has signs of declining kidney function, treating them with medication or educating them on dietary and lifestyle modifications they can make now, before the disease gets any worse.

To review the guidelines, visit the National Kidney Foundation’s web site at: http://www.kidney.org/professionals/doqi/index.cfm.

They also are published in the February issue of the American Journal of Kidney Diseases (2002;39:supplement).

Sources:
Baker, Beth. “Earlier Kidney Testing Urged.” The Washington Post. February 5, 2002: F1, F4.

National Kidney Foundation. “Under-Diagnosed Medical Condition Threatens More Than 40 Million Americans with Kidney Failure.” February 5, 2002.