Saving Kidneys With Simple Testing

In November 2004, the International Societyof Nephrology (ISN) asked national healthbodies around the world to consider the urgentimplementation of proactive albumin (protein)screening in urine.

The ISN says that doing so will allow for earlydetection of kidney damage, followed bytreatment to prevent further deterioration ofthe kidney, thus reducing the number of patientssuffering from kidney failure, heart failure and diabetes.

“We believe that early detection of [kidney] impairment, followed by preventive treatment, is now a global health priority,” says professor Jan J. Weening, president of the International Society of Nephrology. “We now know that simple testing for albuminuria is extremely efficient as an early indicator of renalmalfunction. It is essential that high-riskpatients are systematically screened in theimmediate future and advisable to extend thisto the public at large as a second step.”

Professor Dick de Zeeuw, head of thedepartment of clinical pharmacology at theUniversity Medical Centre in Groningen,the Netherlands, adds that patients withalbuminuria are not only at risk for kidneyfailure but also for heart failure and fordeveloping diabetes. Positive levels ofalbumin in the urine indicate a generalizedcardiovascular risk.

Source: The InternationalSociety of Nephrology

Did You Know?

Kidney failure, heart failureand diabetes account for the major portion ofhealthcare budgets today.

Source: The International Societyof Nephrology

Did You Also Know?

More than 60 million individualsworldwide are estimated to havesome degree of chronic kidneydisease.

Source: The International Societyof Nephrology

Clinical adviser’s note:

A normal laboratory value for albumin in urine is less than30 micrograms per milligram of creatinine. Abnormalresults are microalbuminuria of 30 to 299 micrograms permilligram and macro (clinical) albuminuria of 300 or greater.

Due to variability in urinary albumin excretion, theAmerican Diabetes Association recommends that two of threespecimens within a three- to six-month period wouldhave to test as abnormal before considering a patientto have crossed one of these diagnostic thresholds.

It should be noted that exercising within 24 hoursof testing, infection, fever, congestive heart failure,marked high blood glucose levels and marked high bloodpressure levels may elevate urine albumin excretion.Everyone with diabetes should have an annual test for kidneyfunction starting at diagnosis for type 2s and generallyfour years after diagnosis for type 1s.

To help slow the progression of kidney impairment,angiotensin converting enzyme (ACE) inhibitorsor angiotensin receptor blockers (ARBs) should beused for treatment. For more information about thesedrugs, which are generally used to treat hypertension, seeour chart on page 52 of the January 2005 issue.

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