Combining two common medical tests provides new way to screen for serious kidney disease

Jul 7 2009

The combination of two common medical tests can improve a doctor's ability to predict which patients will develop serious kidney disease, a research team led by the Norwegian University of Science and Technology (NTNU) reports in a recent issue of the Journal of the American Society of Nephrology.

The researchers, led by Stein I Hallan at NTNU's Faculty of Medicine, found that combining two common medical tests - measuring creatinine in the blood and albumin in the urine - improves a doctor's ability to detect early stages of serious kidney failure.

The researchers used data from the population-based Nord-Trøndelag Health Study (HUNT 2, 1995-1997) to examine information from 65,589 adults. Of these, 124 progressed to end-stage renal disease after 10.3 years.The finding also has significance for cardiovascular disease, which often goes hand in hand with chronic kidney disease.

Kidneys play an important role in regulating the body's fluids and salt balance, and cleanse the blood of waste products. More than ten percent of the world's population has a chronic kidney condition, which means that the kidneys gradually stop working. In spite of this widespread prevalence, relatively few individuals develop renal failure severe enough to require dialysis or transplantation.

The catch has always been to figure out which of the patients with chronic kidney disease are likely to go on to the more severe and debilitating version of the illness, so that doctors can intervene early to try to prevent it. The NTNU study provides exactly that -- a more precise screening tool to assess the future risk of kidney failure.

In the United States alone, 785 000 people are expected to develop severe kidney failure in 2020, with treatment estimated to cost upwards of USD 32 billion annually. Doctors and researchers are therefore eager to find ways to make a diagnosis as early as possible.

Chronic kidney disease is also an indicator of high risk for cardiovascular disease.

Medical researchers at St. Olavs Hospital in Trondheim and NTNU have previously shown that the combination of the two tests is a very useful tool for assessing future cardiovascular disease risk, especially in older patients.

Other cooperating researchers for the study came from Ruperto Carola University in Heidelberg and the University of Regensburg, both in Germany. The study has been published in the Journal of the American Society of Nephrology.

Full bibliographic information: Combining GFR and Albuminuria to Classify CKD Improves Prediction of ESRD -- Stein I. Hallan, Eberhard Ritz Stian Lydersen, Solfrid Romundstad, Kurt Kvenild and Stephan R. Orth. J Am Soc Nephrol 20: 1069-1077, 2009