STORY BYWhen Grammy Award-winning soul singer Barry White died of kidney failure July 4, his death focused attention on the dangers of kidney disease.
About 10 million Americans have chronic kidney disease, and another 20 million
are at increased risk because they have diabetes, high blood pressure or other
risk factors. According to the National Vital Statistics Report, kidney disease
causes more than 39,000 deaths annually in the United States.
Research by University of Texas Medical School at Houston physician
Austin Stack, emphasizes the importance of early diagnosis and treatment.
Over one third of patients with end-stage renal disease in the U.S.
see a nephrologist, or kidney specialist, for the first time within
four months of starting dialysis. This greatly increases risk of
death, according to Stack’s study, which was published in the
February issue of the American Journal of Kidney Disease.
Within the first year of dialysis, patients whose first visit to a nephrologist
was less than four months before they started dialysis had a 68 percent higher
risk of death than those whose first visit was earlier.
Patients with early treatment – who saw a nephrologist at least twice in
the year before starting dialysis – had a 20 percent lower risk of death
than those without early treatment.
“Early referral to a nephrologist provides an enormous opportunity for
managing the complications of chronic kidney disease and ensures optimal preparation
for patients who require dialysis or kidney transplant,” said Stack, an
assistant professor of medicine and a clinical epidemiologist in the Division
of Nephrology and Hypertension at the Medical School.
“The study shows for the first time in a nationally representative sample
a clear association between early and frequent nephrology contact and improved
patient survival,” he said. Stack based his findings on an analysis of
2,264 patients from a national study of the U.S. Renal Data System.
Seeing a specialist early in the course of kidney disease allows for more effective
treatment of hypertension, anemia and other related medical conditions, such
as diabetes, coronary artery disease and congestive heart failure. In some cases,
he said, declining kidney function can be halted, delayed or even reversed, avoiding
the need for dialysis or transplant.
A new National Kidney Disease Education Program, under the auspices of the National
Institutes of Health, is encouraging people in high-risk categories – those
with hypertension, diabetes or a relative with kidney problems – to ask
their physicians to be tested. Early efforts are targeted at black Americans,
who are four times more likely than others to suffer kidney failure.
UPDATED: 10-02-2003
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