Growth Of Chronic Kidney Disease Highlights Need For Early Detection, Greater Knowledge Of Treatment Options

Main Category: Urology / Nephrology
Also Included In: Diabetes;  Hypertension
Article Date: 12 Mar 2010 - 2:00 PDT

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As the incidence of diabetes and hypertension continues to grow worldwide - and increasing numbers of patients progressing to kidney disease and kidney failure place a financial strain on public health systems - the need for early patient education about kidney disease and treatment options, including home-based treatments, has become critical.

More than 240 million people have diabetes and this figure is projected to rise to 380 million by 20251. In the United States alone, 17.9 million have been diagnosed with diabetes resulting in medical and indirect costs (e.g., lost workdays, restricted activities and disability) of $174 billion or approximately one of every five health care dollars spent in US2, 3. About 40 percent of people with diabetes will develop chronic kidney disease, which also increases the risk of cardiovascular or other complications4. Today, 26 million American adults have chronic kidney disease and millions of others are at increased risk5.

"People with diabetes or hypertension, over the age of 60 or with a family history of kidney disease are at higher risk of progressing to chronic kidney disease. These patients should undergo screening and talk to their doctor about this disease regardless of if they display symptoms," said Sarah Prichard, MD, vice president of global clinical affairs for Baxter's Renal business. " Early detection of chronic kidney disease can dramatically affect how long you can preserve kidney function, what treatment options you will have and ultimately determine the quality of life you will experience while living with the disease."

Baxter encourages patients with diabetes or hypertension around the world to learn about the symptoms and treatment options for chronic kidney disease on World Kidney Day, March 11. World Kidney Day is a global health campaign of The International Society of Nephrology (ISN) and the International Federation of Kidney Foundation (IFKF) that raises awareness about the importance of our kidneys and reducing the frequency and impact of kidney disease and its associated health problems.

According to two recent studies, chronic kidney disease patients who received early guidance from their nephrologist about their condition and dialysis treatment had a significantly lower risk of death within the first year of treatment6, 7. Studies have also demonstrated that people living with kidney disease who are informed about treatment options and are given a choice more often choose a home therapy.

Several studies report that patients on peritoneal dialysis, the most common type of home dialysis, are more satisfied with their care and experience a reduced impact of kidney disease on their lives compared to patients receiving in-center hemodialysis8, 9. In addition, home dialysis is cost-effective, associated with continued employment10 and can offer more flexibility and time for family and social activities. Recent studies also indicate that more than 75 percent of dialysis patients are eligible to choose either a home or center dialysis modality11, 12.

Recently, a new Medicare benefit went into effect that provides chronic kidney disease patients with six face-to-face kidney disease and treatment options education sessions, and provides physicians and certain physician extenders with reimbursement for educating patients. These classes are intended to educate patients about ways to slow the rate of kidney function loss, attenuate complications associated with kidney failure and provide them with information about treatment options (transplant, home dialysis, or in-center dialysis).

"It is important for people with diabetes and hypertension to learn as much as possible about the progression of kidney failure to prevent complications from chronic kidney disease," said Prichard. "If kidney replacement treatment is necessary, patients should learn about all of their treatment options to select one that is best suited to their condition and lifestyle."

The human kidney works to remove wastes and fluids from the body. When kidney disease progresses, the kidneys work less and less effectively. If the disease is detected early, lifestyle changes and selected medications can preserve kidney function for a longer period of time. If the disease progresses, people living with kidney disease must depend on renal replacement therapies, usually in the form of dialysis or transplantation, to make up for lost kidney function in order to survive. People may receive dialysis treatment at home (peritoneal or home hemodialysis), or in a dialysis center or hospital (in-center hemodialysis).

For more information on kidney disease screening and treatment options, visit http://www.renalinfo.com

1. The International Society of Nephrology and the International Federation of Kidney Foundations, World Kidney Day: Prevalence of Disease, see here.

2. American Diabetes Association, Diabetes Statistics 2007, see here.

3. The Centers for Disease Control and Prevention, Diabetes Statistics and Research: Frequently Asked Questions, see here.

4. The International Society of Nephrology and the International Federation of Kidney Foundations, World Kidney Day: Prevalence of Disease, see here.

5. National Kidney Foundation, Chronic Kidney Disease (CKD), see here.

6. Bradbury B., et.al., "Predictors of Early Mortality among Incident US Hemodialysis Patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS)," Clinical Journal of the American Society of Nephrology, no. 2 (2007), 89-99.

7. Hasegawa T., et. al., " Greater First-Year Survival on Hemodialysis in Facilities in Which Patients Are Provided Earlier and More Frequent Pre-nephrology Visits ," Clinical Journal of the American Society of Nephrology, no. 4 (2009), 595-602.

8. Carmichael P, et. al. "Assessment of quality of life in a single centre dialysis population using the KDQOL-SF questionnaire." Qual Life Res, (2000), 9:195-205.

9. Kutner NG, et. al. "Health status and quality of life reported by incident patients after 1 year on haemodialysis or peritoneal dialysis." Nephrol Dial Transplant, (2005), 20:2159-2167.

10. Paul M. Just, et.al., "Reimbursement and economic factors influencing dialysis modality choice around the world," Nephrology, Dialysis, and Transplantation, January 30, 2008, no. 23, 2365-2373.

11. Mendelssohn D., et. al., "A Prospective Evaluation of Renal Replacement Therapy Modality Eligibility," Nephrology Dialysis Transplantation, (2009) 24: 555-561.

12. Little J., et. al. "Predicting a Patient's Choice of Dialysis Modality: Experience in a United Kingdom Renal Department. American Journal of Kidney Disease, 2001; 37: 981-986

Source
Baxter International Inc.

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