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Wednesday, March 11, 2009
Statement of Griffin P. Rodgers, M.D., Director, National Institute of Diabetes and Digestive and Kidney Diseases for National Kidney Month and World Kidney Day
Kidney disease is common, serious and treatable. Yet most Americans who have kidney problems still don't know it because they don't have symptoms, hampering efforts to prevent kidney failure. As part of its ongoing commitment to support research and to raise awareness about kidney health and how kidney disease can be prevented and treated, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health (NIH), joins with other organizations to observe National Kidney Month in March and World Kidney Day, March 12.
If you have diabetes, high blood pressure, heart disease, vascular disease, or kidney disease in the family, you are at risk for kidney problems. Blood and urine tests are the only way to find the disease early, when treatment is more likely to significantly delay or prevent kidney failure. To help protect the kidneys, I urge you to carefully control high blood pressure — and blood sugar if you have diabetes — and ask your doctor if you should take an ACE (angiotensin-converting enzyme) inhibitor or ARB (angiotensin receptor blocker).
No one is immune from kidney disease. It strikes children and adults and people of all races and ethnicities. It runs in families, disproportionately affecting African-Americans and Native Americans. Kidney disease can lead to kidney failure, premature death, heart attacks, strokes, bone disease, and growth and development problems in children. Diabetes and high blood pressure are the top causes of kidney problems, but kidney disease also can be caused by autoimmune, infection-related, and scarring diseases such as IgA nephropathy, membranous nephropathy, and focal segmental glomerulsclerosis and by inherited and congenital diseases such as polycystic kidney disease and vesicoureteral reflux.
NIH–supported research has shown that the burden of chronic kidney disease and kidney failure is growing. The increase in diabetes and in the U.S. population — and the graying and increasing obesity of our population — mean more people than ever are getting and living with kidney problems. Chronic kidney disease now affects about 27 million people in the United States, up an estimated 20 to 30 percent over the past 10 years. The incidence of chronic kidney disease in 2006 was more than 100,000, or 360 per 1 million people, an increase of 3.4 percent over the 2005 incidence rate. There were more than half a million patients with end-stage kidney disease in 2006. Of these, 70 percent were on dialysis. Medicare paid about $70,000 per dialysis patient. Patients with end-stage kidney disease accounted for a little more than 1 percent of the Medicare population and more than 7 percent of Medicare costs. Total cost for end-stage kidney disease was $33.6 billion. More than 18,000 kidney transplants were performed in 2006, an increase of 3.5 percent over 2005.
At NIH, we are committed to promoting medical research to improve patient care. Past NIDDK-supported clinical studies established that tight glucose control and ACE inhibitors prevent or slow kidney disease and other complications of diabetes. Current NIDDK programs are adding to ever-increasing knowledge of kidney disease — from basic research to understand the underpinnings of healthy and diseased kidneys to clinical research involving patients, and from children to adults. Ongoing studies include a trial of magnetic resonance imaging to monitor polycystic kidney disease, more frequent dialysis for kidney failure, and treatment studies for polycystic kidney disease, glomerulosclerosis and vesicoureteral reflux in children.
In line with our mission, NIDDK's National Kidney Disease Education Program (www.nkdep.nih.gov) aims to improve early detection and broaden the use of available treatments by providing clinical tools to enable overextended health care providers to detect and treat chronic kidney disease in the primary care setting. Through this ambitious program, we ask labs to automatically report estimated kidney function (eGFR) to find the disease earlier and to use standardized kidney tests, and we offer time-saving tools to improve communication between kidney specialists and primary care physicians. Visit our Web site to learn about other NKDEP activities and information available for people at risk and for the health professionals who care for them.
Finally, I hope you will consider participating in clinical trials (www.clinicaltrials.gov) and remember: if you are at increased risk for kidney disease, get tested. If you have high blood pressure, carefully control your pressure and ask your doctor if you should take an ACE inhibitor or ARB for your kidneys. And if you have diabetes, also carefully control your blood sugar.
NIDDK, part of NIH, conducts and supports basic and clinical research and research training on some of the most common, severe and disabling conditions affecting Americans. The Institute's research interests include: diabetes and other endocrine and metabolic diseases; digestive diseases, nutrition, and obesity; and kidney, urologic and hematologic diseases. For more information, visit www.niddk.nih.gov.
The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
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