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.
A new report published this month in the Annals of Internal Medicine, questioned whether widespread screening for chronic kidney disease is worthwhile. Authors said there have been no studies on the benefits or harms of population-wide screening for chronic kidney disease. When reviewing the literature, however, they did find evidence that certain treatments can slow the progression of the disease. Overall, kidney-protective blood pressure medicines called ACE inhibitors and angiotensin II-receptor blockers (ARBs) lowered the risk of end-stage kidney disease by about one-quarter to one-third. Researchers said that benefit was largely limited to people with diabetes and high blood pressure. They noted that these these same patients will usually automatically have their glomerular filtration rate (GFR) reported after routine blood work at their doctor's and so questioned the need for screening.
The National Kidney Foundation recommends and advocates for screening of populations at risk for Chronic Kidney Disease (CKD) in contrast to widespread or mass screening. As the researchers noted, screening, detection and treatment does benefit those with diabetes and high blood pressure --the major CKD risk factors. Together, these conditions affect 73 million or 1 in 3 Americans and so screening this group routinely could have a major impact on public health. In fact, this has already begun to happen. The annual incidence rate of kidney failure attributed to diabetes has been improving in all regions of the U.S., according to the CDC.
These improvements have occurred after practice guidelines were disseminated by both the American Diabetes Association and the National Kidney Foundation which call for enhanced detection of CKD in individuals with diabetes, followed by interventions to prevent or delay diabetes complications. The National Kidney Foundation offers free screening to those at risk through its Kidney Early Evaluation Program and has found that educating those at risk about their GFR score-- a measure of kidney function--so they understand what's normal and what they need to do to keep those numbers in the normal range, has been helping advance health.