Study shows marked difference between Americans and leaner Norwegian patients. Compared to Europeans, Americans with chronic kidney disease (CKD) are more than twice as likely to progress to end-stage kidney disease, researchers say, and higher rates of obesity and diabetes may be to blame.
The researchers compared 65,000 Norwegians and 20,000 Americans in an attempt to gain a better understanding of why the incidence of end-stage renal disease (ESRD), as well as permanent loss of kidney function requiring dialysis or kidney transplantation, is so much higher in the United States than in Norway.
The study authors noted that overall prevalence of CKD is similar in both countries — 11 percent in the United States and 10.4 percent in Norway. However, once a person develops CKD, the risk of progression to ESRD was found to be 2.5 times higher among American patients.
American and Norwegian ESRD patients are similar in many ways, including age and level of remaining kidney function when they begin dialysis, the study noted. However, the American patients in this study had much higher rates of obesity and diabetes, which are two major and closely related risk factors for kidney disease.
"Obesity and physical inactivity lead to high blood pressure and type 2 diabetes, which are now the most important causes of ESRD," study leader Dr. Stein Hallan, of St. Olav University Hospital in Trondheim, said.
The study also found that kidney function among American patients was much lower when they had their first visit with a kidney specialist (nephrologist).
"Early referral to a nephrologist is important," Hallan said. "It often results in better control of diabetes and high blood pressure, as well as early and more adequate correction of anemia and disturbances in electrolyte balance. This reduces the rate of kidney disease progression, and in many patients postpones the start of dialysis."
American Society of Nephrology, news release, June 28, 2006
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