Avoiding a kidney calamity: A matter of numbers

With recognition growing that intervening early is possible and beneficial, primary care doctors are taking a more active role in treating chronic kidney disease.

By Victoria Stagg Elliott, AMNews staff. Oct. 2, 2006.

Just a few years ago, kidney care did not rank high on the priority list of family physician Chester Fox, MD. That changed after he participated in a National Kidney Foundation event designed to raise awareness about what primary care physicians can do for patients who have chronic kidney disease. As a result, he decided to review his charts and think more carefully about the role this organ played in his patients' overall health.

"I started looking at my hypertensives and diabetics, and it was scary," said Dr. Fox, professor of clinical family medicine at the University at Buffalo -- State University of New York. "I thought I was doing a decent job, but I was ignoring elevated creatinines. A lot of them had mild anemia that I was ignoring."

He now speaks regularly on why kidney care is important to primary care physicians and is one of a growing number of non-nephrologists who are paying more attention to it because of a convergence of population-wide health trends and new data suggesting that early action is both feasible and important.

One of the most notable factors driving interest is the sheer number of people who have some form of kidney disease. According to a study published in the January 2003 American Journal of Kidney Diseases, an estimated 19.2 million people have some form of it. The number of patients on dialysis or in need of a transplant is approaching half a million and increasing approximately 4% per year, according to the U.S. Renal Data System, which tracks end-stage kidney disease.