Kidney disease screening urged for those with diabetes, hypertension

The National Kidney Foundation has issued a recommendation that urges kidney disease screening with a urine albumin test as part of the annual physical examination for all patients with diabetes and hypertension, those aged older than 60 years and those with a family history of kidney failure.

The recommendation was based on a new report published in the American Journal of Kidney Diseases that indicated the lifetime risk for moderate or severe kidney disease in Americans was 59.1%, and other analyses about the increased prevalence of kidney disease.

“These new data show clearly that Americans are more likely than not to develop kidney disease, which — in its later stages — is physically devastating and financially overwhelming,” Beth Piriano, MD, president of the National Kidney Foundation, said in a press release. “Importantly, if caught early, the progression of kidney disease can be slowed with lifestyle changes and medications. This underscores the importance of annual screenings, especially within the at-risk population, to potentially prevent kidney disease and ensure every patient with kidney disease receives optimal care.”

The study, by a team from Johns Hopkins University, combined nationally representative prevalence data on 27,475 individuals with kidney disease-associated mortality risk data from more than 2 million Americans to create a model that detailed lifetime risk, according to the press release.

The lifetime risk for moderate kidney disease was 59.1%, which translates to 135.8 million people who will eventually develop the disease. The calculated lifetime risk was 33.6% for moderate to severe kidney disease, 11.5% for severe kidney disease and 3.6% for end-stage kidney disease requiring dialysis or transplantation. Overall risk was highest in women and blacks.

The researchers said one reason why screening for kidney disease is important is that chronic kidney disease “may carry a [CHD] risk similar to that of diabetes.”

“With more than half of all Americans at risk, it’s time for all Americans to understand how kidney disease is detected, and for those at elevated risk because of older age, diabetes, hypertension or other risk factors to know whether they have kidney disease or not,” researcher Josef Coresh, MD, PhD, professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, stated in the release. “Chronic kidney disease is significantly underdiagnosed and the consequences of this lack of information can be dire.”

For more information:

Grams ME. Am J Kidney Dis. 2013;62:245-252.

Disclosure: Coresh has consulted for Amgen and Merck and has an investigator-initiated grant from Amgen. The other researchers report no relevant financial disclosures.