Chronic kidney disease on the rise; preventive testing is critical for diabetic patients

Nov 11 2009

New data confirms the rate of chronic kidney disease is inching upward, keeping pace with the rising rates of diabetes. In late September, the U.S. Renal Data System published its 2009 Annual Data report, which shows the incidence of chronic kidney disease in the U.S. Medicare population is now 9.8%, up from 8.7% reported in last year’s data analysis.

Diabetes, the leading cause of kidney disease, moved closer to affecting one in four Medicare beneficiaries nationally: the newest data shows 24.8% have this disease, up from the 23.6% reported a year earlier. The Texas Department of State Health Services estimates more than 1.8 million Texans have diabetes.

Dallas-based nephrologist Roberto Collazo-Maldonado, MD, is not surprised by the data.

“Because Texas has a big problem with diabetes,” Dr. Collazo says, “more people will get kidney disease. If we find it early, we can effectively treat kidney disease to prevent and avoid dialysis. That is, if we find it early.”

The American Diabetes Association recommends people with diabetes check their kidneys with an annual microalbumin test. However, fewer than 40% of Texas Medicare beneficiaries with diabetes received this screening in 2007, according to claims data from the Centers for Medicare & Medicaid Services².

“I regularly see patients who discover they have kidney disease when they come to the hospital for emergency treatment because their kidneys have failed,” Dr. Collazo continues. “This is too late. People with diabetes must check their kidney health every year.”

Why preventive testing is critical for people with diabetes

“It’s optimal to treat kidney disease before the damage is apparent to the patient,” says Dr. Collazo. “In the earliest stages, it’s unlikely the patient will experience obvious symptoms that would prompt a doctor’s visit.”

The urine microalbumin test looks for traces of albumin, a protein, in a patient’s urine. Damage impairs the kidneys’ ability to filter the blood for proteins, which then “spill” into a patient’s urine. This is an early marker of kidney disease.

“Getting a microalbumin test is very easy. It’s just a urine sample. No needles and no pain,” says Dr. Collazo. “If we find kidney disease at the early stages, we can treat it and most likely avoid dialysis. Not everyone with kidney damage progresses to kidney failure, but first you have to get tested regularly and then get timely treatment to prevent that outcome.”

People with diabetes and minorities at higher risk

Up to 40% of people with diabetes will experience kidney problems in their lifetime.³ Minorities with diabetes are also disproportionately affected: African-Americans are four times more likely than Caucasians to experience kidney failure, and Mexican-Americans with diabetes are twice as likely as non-Hispanic whites to have diabetes.^4,5

Accounting for 44% of new cases, diabetes is the leading cause of kidney disease, the U.S. Renal Data System reported in 2007. The second leading cause is high blood pressure.⁶ Other risk factors are age, obesity and a family history of kidney problems.