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Winter 2009

Early Detection Is Key to Successful Treatment of Chronic Kidney Disease

01/01/2009

People at risk are encouraged to ask their doctors for a simple screening test. 

If detected early, chronic kidney disease can be effectively treated and managed. Unfortunately, most cases of chronic kidney disease are not detected early, when treatment is most likely to prevent serious complications, says UCLA nephrologist Brian Young, M.D.

“The problem is that by the time people have symptoms, the disease is well advanced,” he says. “And even when symptoms occur, they can be vague and ignored for quite some time.”

For that reason, people who are at risk for kidney disease should ask their physicians for the simple blood or urine screening tests that are available. Anyone over the age of 60 or who has diabetes, hypertension, is obese and/or has a family member with kidney disease should be screened.

Chronic kidney disease is far more common than most people realize — approximately 26 million people in the United States have the condition, and that number is expected to increase. “This disease is a major public-health problem,” Dr. Young says.

Early detection can help to treat and slow the progression of the disease, as well as control its complications. But if not detected and treated promptly, the consequences can include kidney failure necessitating dialysis or transplantation; anemia; and, for reasons that are not fully understood, a significantly elevated risk of cardiovascular disease. A patient with moderately advanced chronic kidney disease has about 20 times the chance of dying of heart disease as he or she does of living long enough to develop end-stage kidney disease, Dr. Young says.

Chronic kidney disease can be managed through tight control of blood sugar for people with diabetes and control of blood pressure for people with hypertension, as well as with the use (even for nonhypertensive patients) of the classes of blood-pressure medication known as angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs). “The most important thing is to start treatment as early as possible,” Dr. Young says, “because if you can prevent the disease from progressing to a certain point, the most severe consequences are unlikely to occur.”





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