Rise in chronic kidney disease turns focus to risk factors

Surveillance is improving, but experts say a better way is needed to determine the true number of people affected.

By Victoria Stagg Elliott, AMNews staff. April 9, 2007.

Public health officials and epidemiologists are trying to get a better grasp of the true prevalence of chronic kidney disease and associated risk factors because studies suggest that this condition is becoming increasingly common.

A paper in the March 2 Morbidity and Mortality Weekly Report analyzing data from the 1999-2004 National Health and Nutrition Examination Survey concluded that 16.8% of the population had some form of CKD.

This finding represented an increase of 15.9% from the 1988-1994 NHANES. This study also found having diabetes, cardiovascular disease and hypertension increased the risk, and that a majority of patients were at the early stages with very few having advanced disease.

"The majority are not even getting to the end stage, and we need to get a firmer handle on that," said Rashida Dorsey, PhD, senior author and an Epidemic Intelligence Service officer at the Centers for Disease Control and Prevention.

In addition, a study published in the April Journal of the American Society of Nephrology estimated that 9.5% of the population had a first-degree relative with end-stage renal disease. Those with this CKD risk factor were also more likely to have diabetes and be obese. African-Americans with a family history were also more likely to have impaired kidney function themselves. This finding, however, did not hold true with Caucasians.

"We found a very high prevalence of older adults in our population who reported a family member on dialysis or having had a transplant," William McClellan, MD, MPH, lead author and professor of medicine in the departments of medicine and epidemiology at Emory University in Atlanta.