What is Kidney Count?
Kidney Count is a public awareness campaign to introduce the importance of glomerular filtration rate (GFR). For the general public's understanding, Kidney Count will be used to refer to a person's GFR. The goal of the campaign is to make Kidney Count a familiar number to South Carolinians much like cholesterol or blood pressure.
How did Kidney Count come about?
Two events have granted increased importance to utilizing GFR/Kidney Count:
- Introduction in 2001 of the National Kidney Foundation Kidney Disease Outcome Quality Initiative (K/DOQI) guidelines for early intervention of chronic kidney disease (CKD).
- 2006 South Carolina Task Force on Chronic Kidney Disease.
Both initiatives reinforce the significance of early diagnosis and treatment of CKD and recognize that CKD is under diagnosed and under treated. Supported by evidence that CKD progression can be slowed and armed with the appropriate tools, the primary care provider can manage early stages of CKD. The recommended diagnostic tool is the GFR/Kidney Count. Ongoing efforts both nationally and statewide introduce and teach healthcare professionals its importance. But Kidney Count will be the first comprehensive effort in South Carolina.
Under the guidance of the Medical Advisory Board of the NKF Serving the Carolinas, South Carolina Region, it was determined that a GFR/Kidney Count of less than 90 is the best point to look closely at risk factors, causes, and treatment of CKD. A GFR/Kidney Count of less than 90 is considered within the normal range but is indicative of decreasing kidney function and justifies closer evaluation. This Kidney Count is the point at which the general public will be encouraged to "ask your doctor."
The burden of CKD:
- It is estimated that 1 in 8 people in South Carolina (460,000) have CKD.
- Diabetes and hypertension account for 70% of all new CKD cases.
- Patients with CKD die before advancing to late-stage disease. An estimated 7.4 million have stage 3 CKD, but only 300,000 are estimated to have stage 4.
- In 2005, ESRD costs rose to $21 billion – 6.4 percent of the entire Medicare budget.
- Preventing one person from developing end stage renal disease (ESRD) will save between $54,000 and $72,000 per year in healthcare costs depending on the type of healthcare coverage.
- End stage renal disease (ESRD) is second only to lung cancer as a cause of death and leads colorectal cancer, breast cancer, and prostate cancer.
- The mean life expectancy for a person with ESRD is 4 years.
- At current rates for CKD diagnosis, referrals to each nephrologist will average 7 new patients per day which stresses the importance of primary care involvement.
How can Kidney Count assist me in caring for my patients?
- Understanding the definition of CKD based on the K/DOQI guidelines:
- Why use GFR/Kidney Count rather serum creatinine (SCr) only?
- Age, ethnicity, and gender can affect serum creatinine. It is possible to have a normal serum creatinine and actually have decreased kidney function.
- GFR/Kidney Count, since it is a calculation, accounts for these indicators.
- Click this link (http://www.kidney.org/professionals/tools/) to access a GFR calculator. You may use it online or download for PDA use. There are also options for accessing patient care plans from this link.
- GFR/Kidney Count allows you to stage a patient's kidney disease according to the level of kidney function. And, based on the stage, determine a plan of care. The diagram below shows the stages of CKD, GFR/Kidney Count for each stage, a basic definition, and the initial plan of action.
- Understanding which patients are at greatest risk for CKD can identify who to test for GFR/Kidney Count.
- Because early intervention is critical, it is recommended that healthcare providers explore more carefully the risk factors, causes, and treatment of CKD if a person's GFR/Kidney Count is less than 90. The general public is encouraged to “ask your doctor” if their Kidney Count is < 90.
- Kidney Count encourages individuals to take an active role in keeping track of their kidney health and related test results. To help them with this, the NKF Serving the Carolinas, South Carolina Region makes available to them a Kidney Count Tracker where they can write in their “numbers,” compare them to preferred ranges, and write down some individual goals to help them achieve better results.
- To view and print the Kidney Count Tracker, click here.
Where can I get more information on management recommendations and principles for slowing the progression of CKD?
Free CME and practical information about managing patients with CKD is available by clicking on the link below. The audio/PowerPoint program takes about 30 minutes and includes the following topics:
- Identifying and staging CKD
- Complications of CKD including cardiovascular disease, proteinuria, anemia, and bone disease
- Evidence for risk reduction including glycemic control, cardiovascular disease, and blood pressure control with ACEIs or ARBs or combination therapy.
Thank you for your interest in Kidney Count. You may contact the NKF Serving the Carolinas, South Carolina Region for more information at 800-488-2277 or www.kidneysc.org.
