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TUESDAY, June 24, 2003 (HealthDayNews) -- Current screening tests for kidney disease miss an estimated 300,000 Americans who have the illness.
But adding a simple blood test to routine exams could go a long way toward detecting most cases of kidney disease, a particular problem for diabetics, a new study says.
The research appears in the June 25 issue of the Journal of the American Medical Association.
"By estimating the glomerular filtration rate (GFR) using a simple blood test, we can detect kidney disease and implement intervention early," says Dr. Holly J. Kramer, a nephrologist at Loyola University Medical Center in Maywood, Ill., and lead author of the study.
A decrease in a person's glomerular filtration rate, which is a measure of the kidneys' filtering capacity, always occurs before kidney failure, Kramer explains. In addition to diabetics, others at risk of kidney disease include people with a family history of kidney failure or hypertension.
Currently, doctors screening patients at high risk for kidney disease monitor them for the eye disease called retinopathy. Or they check for too much of the protein albuminuria in the urine. Albuminuria can indicate the onset of kidney disease.
These tests pick up the majority of cases of kidney failure, but they miss an estimated one-third of patients, Kramer says. "We need to alert doctors that 30 percent of patients do not have the classic signs of kidney disease," she says.
When untreated, kidney disease leads eventually to kidney failure and the need for dialysis, a procedure that costs the U.S. government $15 billion annually through its Medicare program. Almost 40 percent of kidney failure, called end-stage renal disease, is attributed to type 2 diabetes.
"This is a really important study and point to make," says Dr. Kathy Tuttle, chairwoman of the National Kidney Foundation's work group on Diabetes in Chronic Kidney Disease. "It's another step in the direction of more complete evaluation and better information about kidney disease in diabetes."
"If you know people have kidney damage and can pick it up this way, you can intervene in a way to prevent or delay dialysis, which, in addition to its cost, is a quality-of-life issue," she says.
Intervention treatments include reducing blood pressure, blood sugar levels and proscribing a healthy lifestyle for patients, Kramer says.
For the study, Kramer and her colleagues examined data from 1,197 people, aged 40 or older, who had type 2 diabetes. Thirteen percent of them had chronic renal insufficiency, or kidney disease.
Of that group, 28 percent had retinopathy, and 45 percent had high levels of albuminuria in their urine.
But 30 percent of those with chronic renal insufficiency had neither warning sign. Extrapolating out, Kramer estimates that approximately 300,000 Americans are at risk of undetected kidney disease.
More information
The National Kidney and Urologic Diseases Information Clearinghouse provides extensive information on kidney disease and diabetes. Additional advice on monitoring kidney disease can be found at The National Diabetes Information Clearinghouse.
