Nov. 6, 2007 -- Thirteen percent of Americans now have chronic kidney disease, up 3% over the last decade, mostly due to higher rates of diabetes and high blood pressure.
Kidney disease ranks low on America's radar screen. But it's a major killer. While many patients with chronic kidney disease go on to die of kidney failure, many more of these patients die of heart disease.
Johns Hopkins University researcher Josef Coresh, MD, PhD, and colleagues analyzed data from the two most recent National Health and Nutrition Examination Surveys (NHANES). These CDC surveys collected data -- including physical examinations with blood and urine tests -- on 15,488 Americans from 1988 to 1994 and on 13,233 Americans from 1999 to 2004.
According to their conservative analyses, 10% of Americans had chronic kidney disease between 1988 and 1994 and 13% of Americans had chronic kidney disease between 1999 and 2004.
Driving the increase is a dramatic rise in diabetes and high blood pressure. Each of these conditions can lead to kidney disease.
A recent CDC report on the same NHANES data suggested that 17% of Americans have chronic kidney disease. Coresh and colleagues came up with a lower number because the CDC analysis included people with earlier signs of kidney disease, while the Coresh team counted only those with persistent kidney disease.
Even the lower number is of great concern.
"The high prevalence of chronic kidney disease overall, and particularly among older individuals and persons with [high blood pressure] and diabetes, suggests that chronic kidney disease needs to be a central part of future public health planning," Coresh and colleagues conclude.
Highlighting the problem is a "Health Trends" report from Quest Diagnostics, a national network of laboratories and patient-service centers.
The report, based on Quest Diagnostics test results from 2005 to 2006, shows that the majority of patients with diabetes and/or high blood pressure do not regularly get an inexpensive test to check for protein in the urine, an early sign of kidney disease.
"More aggressive monitoring in the early stages of kidney disease allows more time for evaluation and intervention," Joseph A. Vassalotti, MD, chief medical officer of the National Kidney Foundation, says in a news release. "We need to work together to promote implementation of early detection and treatment of chronic kidney disease."
Early treatment for kidney disease can protect against permanent kidney damage. And at the first sign of kidney disease, people should take steps to cut their risk of heart disease.
The Coresh study appears in the Nov. 7 issue of The Journal of the American Medical Association.