October
2007
Strep Throat - Say,
Chronic Kidney Disease (CKD) affects about 20 million American adults (1 in 9). CKD as defined by the National Kidney Foundation-Kidney Disease Outcomes Quality Initiative workgroup: “The presence of markers of kidney damage for 3 months, as defined by structural or functional abnormalities of the kidney with or without decreased glomerular filtration rate (GFR), that can lead to decreased GFR, manifest by either pathological abnormalities or other markers of kidney damage, including abnormalities in the composition of blood or urine, or abnormalities in imaging tests OR The presence of GFR <60 mL/min/1.73 m2 for 3 months, with or without other signs of kidney damage as described above. “
So basically means the kidneys are filtering the blood too slowly, and/or the kidneys are not filtering well and allowing proteins to spill through. GFR can be calculated by collecting a 24 hour urine sample, but now a days it is easier to estimate it by checking the blood and using some equations based on age, sex, weight, height. Normal GFR is 90-125/ml/min per 1.73m2
Stage 1 CKD: normal GFR but albumin in urine (a protein)
Stage 2 CKD: GFR 60-89 with albumin in urine
Stage 3 CKD: GFR 30-59
Stage 4 CKD: GFR 15-29
Stage 5 CKD (ESRD): <15
The Medicare-funded End-Stage Renal Disease (ESRD) program continues to increase. In 1973 there were 10,000 beneficiaries and in 2004 there were 472,099. Perhaps preventing CKD and managing CKD before it progresses to ESRD will save lives. Also the ESRD program cost about $32.5 billion in 2004, and it is anticipated another $28 billion more by 2010.
Risk factors for CKD include: High Blood Pressure, Diabetes, Family History, Older Age, Autoimmune Diseases like Lupus, Kidney stones, Kidney toxic drugs. US ethnic minorities have more CKD than US Caucasions, including African Americans, American Indians, Hispanics, Asian or Pacific Islanders
Screening/Testing: Blood creatinine to estimate the GFR. Urine for albumin/creatinine ratio to estimate if there is microalbumin – a even earlier detection of CKD.
CKD and Morbidity: many people with CKD have cardiovascular disease as well. Those with CKD have increased hospitalization by 3x. Mostly quality of life is decreased in CKD.
www.kidney.org and www.kidneyva.org are resources
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