Screening, kidney disease: Screening (looking) for early kidney disease in people who are not already known to have it. Kidney disease is common and is commonly insidious in onset. The burden of kidney disease in its earlier stages lies not only in the risk of progression but in the complications of decreased kidney function and the risk of heart disease.
In 2002 the National Kidney Foundation (NKF) set forth guidelines for kidney disease screening. It recommended that all individuals at increased risk for chronic kidney disease have their blood pressure measured and their blood and urine tested for signs of impaired kidney function. Those at increased risk for chronic kidney disease were defined as people with: - Diabetes
- High blood pressure or a
- Family history of kidney disease
In the US population, the NKF guidelines also identified older Americans, African-Americans, Hispanics, Asians and Pacific Islanders as being at increased risk for chronic renal disease. The NKF recommended three routine tests be used for kidney disease screening, namely: - Blood test for creatinine
- Urine test for protein and
- Measurement of blood pressure
The level of creatinine in the blood is then used to estimate the glomerular filtration rate, or GFR. The GRF and checking for persistent protein in the urine ( proteinuria ) are believed to be the best way to diagnose early kidney damage. The level of GFR and persistent proteinuria can be estimated accurately from blood and urine tests collected during a routine office visit.
The reason for measuring the blood pressure is two-fold. Elevated blood pressure ( hypertension ) is both a cause and a consequence of chronic kidney disease.
Chronic renal disease is a problem of appreciable proportions. In the US alone, the NKF estimated in 2002 that 20 million people had early chronic kidney disease and did not know it, and another 20 million faced an above average risk of developing it. Screening for chronic kidney disease has been generally neglected and is of inestimable value.
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