U. S. Kidney Failure Rate Stabilizes
New research by the National Institute of Diabetes and Digestive and Kidney Diseases indicates the rate of new cases has stabilized.
Schmalfeldt: After 20 years of annual increases in the rate of new cases of kidney disease, there's finally some good news. New research by the National Institute of Diabetes and Digestive and Kidney Diseases indicates the rate of new cases has stabilized. According to the report, the rate of new cases in 2003 was down slightly from 2002 — continuing a four year trend and giving researchers hope that these rate decreases have not been a chance occurrence. Doctor Paul Eggers, one of NIDDK's coordinators for the U.S. Renal Data System, crunched some of the numbers for us.
Eggers: Most of it is occurring in populations that we have reason to believe interventions have had an effect, such as the diabetic population. And that is the population we're most confident that we can attribute the cause of renal disease, and in which the interventions have the most direct effect. And then we have additional information that suggests that the diabetic population is actually receiving these interventions at a higher rate than they used to.
Schmalfeldt: Much of the credit for these recent gains comes from a line of medications that were proven in the 1990s to significantly delay or prevent kidney failure, such as ACE-inhibitors, as well as careful control of diabetes and blood pressure. But even with this good news, the report indicates there are still some dramatic racial disparities. Doctor Eggers explained.
Eggers: The progression from impaired renal function to end stage is much greater among African-Americans than among Caucasian-Americans, and again we don't exactly know why that is. However, these interventions that we're seeing which delay the onset — and we've seen it only in the white diabetic population, that if we could extend those interventions more thoroughly through the African-American population, there's some hope that at least part of that massive difference might be alleviated.
Schmalfeldt: Diabetes and high blood pressure remain the leading causes of kidney disease, accounting for 44 percent and 28 percent of all new cases, respectively. The most striking trends were found in diabetes, where rates for new cases in whites under age 40 were the lowest since the late 1980s — a stark contrast to rates for their African-American counterparts, which haven't budged. Doctor Josephine Briggs is Director of the Division of Kidney, Urologic and Hematologic Diseases at the NIDDK.
Briggs: In diabetics, we have good measures to prevent kidney disease. We have good drugs that keep the blood pressure under control and slow the worsening of kidney disease. Now these aren't used in everybody who could benefit from them and that's why we have a National Kidney Disease Education Program. But they are being used increasingly and, as Doctor Eggers mentioned, the numbers really bear this out; there is more use of these drugs. Our wish and hope and goal of the National Kidney Disease Education Program is to see everyone who could benefit from these treatments getting it.
Schmalfeldt: The National Kidney Disease Education Program, online at www.nkdep.nih.gov offers information about the connection between diabetes, high blood pressure and kidney disease; plus strategies proven to delay or prevent kidney failure, a tool for estimating kidney function to find kidney disease at an earlier stage, and tools for health professionals. From the National Institutes of Health, I'm Bill Schmalfeldt in Bethesda, Maryland.
About This Audio Report
Reporter: Bill Schmalfeldt
Sound Bite: Dr. Paul Eggers, Dr. Josephine Briggs
Topic: Kidney Disease, Diabetes