Fact Sheet: Disease often undetected

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NEW YORK CITY A recent study found that 26 million American adults have CKD and that before being diagnosed through testing, the vast majority didn't know it. "Chronic kidney disease is a silent killer because most people feel fine until it's advanced," says Leslie Spry, MD, spokesperson for the National Kidney Foundation. National Kidney Month (March 2008) and World Kidney Day (March 13) mark a perfect time for health-conscious adults to learn more about CKD and the benefits of early detection.

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In honor of those health observances, the National Kidney Foundation provides answers to the most commonly-asked questions about chronic kidney disease:

1: How common is CKD? A recent study found that prevalence has increased from one in every 10 adults to about one in every 7 to 8-a figure likely to rise more due to high obesity rates (1/3 of all adults), the link between obesity, diabetes and high blood pressure (all risk factors) and the aging of the Baby Boom generation (another risk factor).

2: What health problems can CKD cause? Complications include anemia, bone disorders, malnutrition, loss of kidney function, cardiovascular disease and death-more likely from cardiovascular event than kidney failure, says Dr. Spry.

3: Am I at risk? Primary risk factors include diabetes, high blood pressure, cardiovascular disease, a family history of kidney disease and age over 60. Secondary risk factors include obesity, autoimmune diseases, urinary tract infections, systemic infections, and kidney loss, damage, injury or infection.

4: Can CKD be prevented? Taking care of overall health helps protect kidney health. Wise practices include exercising regularly, low salt diet, controlling weight, monitoring blood pressure and cholesterol levels, not smoking, drinking only in moderation, avoiding NSAIDs and getting an annual physical.

5: What are the warning signs of CKD? Most people have no symptoms until CKD is advanced. "If you wait until you have symptoms to be tested, you've waited too long," says Dr. Spry. Signs of advancing CKD include swollen ankles, fatigue, difficulty concentrating, decreased appetite, blood in the urine and foamy urine.

6: Should I get tested? If you have any risk factors, yes; otherwise, no. "Right now, most people who are at risk aren't being screened," says Dr. Spry, "so we need to focus on them."

7: If I do need to be tested, which tests should I get? The two most essential are a urine test to measure the ratio of albumin (a protein) to creatinine (a normal waste product) in the urine (presence of albumin indicates CKD); and a blood test to measure glomerular filtration rate (GFR)-how well your kidneys filter creatinine out of the blood (the best measure of kidney function).

8: What if a test indicates I may have CKD? First, schedule another test. "You need the results of two tests taken more than three months apart to define the condition," says Dr. Spry. Depending on the results, your doctor may want to monitor your GFR for a while or schedule other tests. The two of you should also discuss and adjust any medications you're taking to reduce stress on your kidneys.

9: If CKD is diagnosed, will I need to see a specialist? Not if it's caught early and you're otherwise in good health. If it's advanced or advancing rapidly, however, or you have other health problems as well, your doctor could recommend that you immediately see a specialist.

10: Can CKD be cured? Usually not, says Dr. Spry, which is why early detection is so crucial. "If it's caught early, it allows more time for interventions that can slow its progress."

To learn more about CKD risk factors, prevention and treatment, visit www.kidney.org. The National Kidney Foundation will also offer free kidney screenings to people at risk for CKD in a number of cities across the U.S. on World Kidney Day, March 13. For locations and schedules, visit www.keeponline.org.

The National Kidney Foundation is dedicated to preventing kidney and urinary tract diseases, improving the health and well being of individuals and families affected by these diseases, influencing public policy in support of the kidney community and increasing the availability of all organs for transplantation.

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