Ask the Doctor
Questions about kidney disease? Risk factors? Signs and symptoms? Are you concerned about yourself, a friend or family member? Ask Dr. Spry.
New York, NY
April 2 , 2003
Twenty million American adults have chronic kidney disease (CKD) and should be considered in the highest risk group for cardiovascular disease (CVD), according to new clinical practice guidelines from the National Kidney Foundation. Designed to help clinicians manage dyslipidemias in patients with CKD, these guidelines recommend regularly measuring lipids and treating any abnormalities to help to reduce the prevalence of CVD in patients with CKD.
"Forty-one percent of Americans with either kidney failure or a kidney transplant died from some form of coronary heart disease between 1997-1999," said Bertram Kasiske, MD, director of nephrology, Hennepin County Medical Center and chair of the work group that developed the guidelines. "Everyone with CKD and all kidney transplant recipients should be evaluated for dyslipidemias, including a complete lipid profile. A patient should be re-evaluated two-to-three months after a treatment change or other condition(s) known to cause dyslipidemias and annually thereafter."
According to Brian Pereira, MD, president of the National Kidney Foundation, the treatment of dyslipidemias complements the recommendations of the third Adult Treatment Panel (ATP III) of the National Cholesterol Education Program. "The concern with the ATP III is that it neither includes nor excludes patients with CKD. Now, clinicians have evidence-based clinical practice guidelines to help manage dyslipidemias within the CKD population."
Published as a supplement to the April issue of the American Journal of Kidney Diseases, the NKF-Kidney Disease Outcomes Quality Initiative (K/DOQI) Clinical Practice Guidelines: Managing Dyslipidemias in Chronic Kidney Disease is the culmination of two years' work reviewing evidence published in peer-reviewed medical journals by volunteer experts in nephrology, pediatric nephrology, epidemiology, laboratory medicine, nutrition, gerontology and social work. This is the first of a series of interventional guidelines to improve the outcomes for patients with CKD.
Chronic Kidney Disease
In 2002 the NKF published Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification and Stratification that found 20 million American adults have CKD and at least 20 million more are at increased risk.
"These guidelines," said Garabed Eknoyan, MD and K/DOQI Co-Chair, "urge physicians to evaluate their patients with diabetes, high blood pressure or a family history of kidney disease for the presence of CKD. "Three simple tests: blood pressure, serum creatinine and urinalysis, along with the estimation of the patient's glomerular filtration rate (GFR) will help diagnose early kidney damage," he said.
"The K/DOQI Clinical Practice Guidelines address various complications and comorbidities of CKD with the goal of improving patient outcomes," said Adeera Levin, MD and K/DOQI Co-Chair. "Upcoming guidelines address CKD and bone metabolism and disease, cardiovascular disease and dialysis and blood pressure."
The Kidney Disease Outcomes Quality Initiative (K/DOQI) provides evidence-based clinical practice guidelines developed by volunteer physicians and health care providers for all phases of kidney disease and related complications, from diagnosis to monitoring and management. K/DOQI expands the Dialysis Outcomes Quality Initiative or DOQI, a project begun by the National Kidney Foundation in 1995 and recognized throughout the world for improving the care of dialysis patients. For more information, please visit www.kdoqi.org.
About the National Kidney Foundation
The National Kidney Foundation is dedicated to preventing kidney and urinary tract diseases, improving the health and well being of individuals and families affected by these diseases, influencing public policy in support of the kidney community and increasing the availability of all organs for transplantation. For more information, please call (800) 622-9010.