Undiagnosed Kidney Disease Common Among Diabetics
Reported June 16, 2005
By Stacie Overton, Ivanhoe Health Correspondent
SAN DIEGO (Ivanhoe Newswire) — New research presented this week at the American Diabetes Associations Annual Scientific Sessions in San Diego shows that undiagnosed chronic kidney disease is common in patients with diabetes and the standard tests used to detect it may not be enough.
Rachel Middleton, a researcher from Hope Hospital in the United Kingdom, presented her research at the meeting. She first explained diabetes is the single most common cause of end-stage kidney failure in the United Kingdom as well as the United States. Up to 30 percent of diabetics will develop nephropathy (or kidney disease).
One of the goals of the study was to determine the effectiveness of standard tests in detecting kidney disease among people with diabetes. One of the tests, called a serum creatinine test, measures the amount of creatinine in the blood to determine if kidney damage is present. A second test measures the presence of microalbuminuria. Albumin is a protein present in the blood. The kidneys act as a filter for waste products in the blood, and protein should not be present in urine. If the kidneys are not filtering waste effectively, this protein may show up in the urine, indicating kidney damage.
More than 7,500 people living in Salford in the United Kingdom were included in the study. Nearly 90 percent of them had type 2 diabetes. More than 6,000 of the patients had undergone a creatinine test within two years, but more than 50 percent had not had a microalbuminuria test, despite guidelines suggesting the test to be done annually.
Nearly 30 percent of patients had later-stage kidney disease that went undetected. Older age and being female increased the likelihood of kidney disease. One important finding that Dr. Middleton points out is that 31.6 percent of females with chronic kidney disease had normal creatinine and normal microalbuminuria levels. She says this suggests the need for better testing among these patients.
One such test is estimated GFR (glomerular filtration rate). According to the National Kidney Foundation, GFR is generally accepted as the best overall index of kidney function in health and disease but measuring it is cumbersome to do in a clinical setting. Because this study showed creatinine tests and microalbuminuria fail to identify a considerable number of people with kidney disease, Dr. Middleton says, Estimated GFR should be incorporated into screening for chronic kidney disease.
SOUCRE: Stacie Overton at the American Diabetes Associations 65th Annual Scientific Session in San Diego, June 10-14, 2005