Significant CKD risk factors not being properly addressed - NKF's KEEP

Transplant News,  Dec 15, 2005  

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Significant risk factors for chronic kidney disease such as diabetes, hypertension or a family history of diabetes are not being properly addressed in the US, according to the National Kidney Foundation (NKF).

The third annual report of the NKF's Kidney Early Evaluation Program (KEEP), which summarized health information on 37,155 individuals at risk for kidney disease, found that half the participants had CKD, yet only 2% were aware of it.

"Awareness of risk factors such as diabetes and hypertension and the need for screening can go a long way toward early detection and prevention of kidney disease," said Allan Collins, MD, NKF president-elect and director of the KEEP Data Coordinating Center.

"Ninety percent of KEEP participants reported visiting their doctors in the last 12 months, yet most were not aware that they could be at risk for chronic kidney disease," Collins added. "While physicians were treating diabetes and hypertension alone, they were not treating them as risk factors for CKD so most of our participants were not tested for kidney disease at their checkups."

The KEEP report found that 77% of the 37,155 participants are obese; 30% have diabetes; more than 50% have hypertension, and only one in four has it adequately controlled. In those with diabetes, only half the patients had blood sugars in the target range.

The report said the right kind of screening is of critical importance. For example, almost half of KEEP participants test positive for microalbuminuria or trace amounts of protein in the urine which is the earliest sign of kidney disease. The number increases to more than 60% of those with diabetes in Stage 3 CKD, 80% in Stage 4 CKD and nearly 100% in Stage 5 CKD.

Collins did say that despite the grim sounding statistics, progress is being made.

"The good news is that we appear to be having an effect on many populations that would advance to dialysis or kidney transplantation. Nearly 60% of KEEP participants provide post-screening follow up information and many report consulting with their physicians regarding elevated high blood pressure, anemia, urine test abnormalities and more," he said. "These findings suggest we should increase our efforts, since the treatments that have been shown to be effective are changing the course of kidney disease, which used to be considered untreatable."

Information on KEEP is available online at: www.keeponline.org

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