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#14
Do You Need - Kidney Tests?
Do You Know Your GFR? What are Your Numbers?
There
are 3 tests recommended now for those at risk for kidney disease.
Many
millions of people are at high risk for kidney disease and don't
know it. If a patient has high blood pressure, diabetes or a
family history of kidney disease or is just a senior citizen then
they need to have a kidney test.
The National Kidney Foundation
recommends, if you have one of these risk factors, that the doctor
should have you take three key tests -- your blood pressure, your
blood creatinine level, and a check for protein in your urine.
High blood pressure is a cause and a complication of kidney
disease. The creatinine blood test measures a waste product
filtered by the kidneys. And the urine protein is a marker of
kidney damage.
NKF's guidelines are largely
geared toward bringing kidney disease prevention into the popular
mainstream, just as heart disease was in the 1980s. Millions of
Americans now know their cholesterol levels and modify their diets
or take medications to lower their chance of developing artery
trouble or suffering a heart attack..
The panel is now recommending
that high-risk individuals--including the elderly, those with
diabetes, high blood pressure or a family history of kidney
disease--get three key tests when visiting their doctor: a test to
measure creatinine levels in the blood, a screen to check for
protein in the urine, and a simple blood pressure measurement.
Studies performed in recent years have linked elevated levels in
each test to an increased risk of kidney disease and possible
failure.
"The message is, 'know your
numbers,'" said Dr. William F. Keane, the president of the
American Kidney Foundation.
The new guidelines were published
in the February issue of the American Journal of Kidney Diseases.
Levey advised Americans to know
their glomerular filtration rate, or GFR (which is estimated from
the creatinine test), a measure of the kidney's ability to filter
blood.
"The same way people with
high blood pressure know their blood pressure number and people
with cholesterol know their cholesterol number, we think people
should come to know their GFR," Levey said. "When you
get to 60 or below, even if there's no evidence, that is chronic
kidney disease, and more medical attention is required at that
point."
The recommendations give doctors
an 'action plan' designed to guide intervention depending on test
results and the stage of kidney disease. The plan includes
medication and lifestyle changes for up to 6 million Americans
whose lab tests may reveal early but symptom-free kidney damage.
Approximately 300,000 Americans
are currently on dialysis, a treatment that requires patients with
kidney failure to hook into a blood-filtering machine several
times a week to stay alive. More than 13,300 other patients
underwent kidney transplants in 2000, and 51,000 more currently
sit on transplant waiting lists, according to the United Network
for Organ Sharing.
Kidney failure kills up to 60,000
Americans each year, and those that survive endure severe
lifestyle restrictions with treatment that costs the health system
some $15 billion per year, Keane said. Much of the cost is born
directly by taxpayers, since the federal Medicare program finances
all end-stage, or advanced, renal disease care in the US.
Obesity and smoking are both
believed to be major causes of the diseases leading to kidney
failure.
Still, experts acknowledged that
many physicians might resist the guidelines since they call for
increased testing in offices that are often pressed for time and
sometimes squeezed for money. Doctors until now have been educated
to view kidney disease mainly in the context of end-stage failure,
not as a chronic, progressing ailment that can be slowed with
treatment or lifestyle change, said Dr. Garabed Eknoyan, a
professor at the Baylor College of Medicine, Houston, Texas, the
co-chair of the NKF's quality outcomes initiative.
"There
will be resistance. That is the tradition with (new)
guidelines," he said.
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FACT:
Of
the 16 million Americans living with diabetes today, three-fourths
will develop cardiovascular disease.
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