Kidney failure, requiring dialysis or transplant, can often be prevented with early detection and treatment of chronic kidney disease. Unfortunately, early detection does not happen often enough. So a research team from Case Western University and the University of Michigan analyzed data from 11,955 American adults to identify risk factors that should alert both doctors and patients to the need for kidney function tests. Here are the top ten from their study:
1. Age. The highest risk factor is living to be more than 60 years old.
2. Macroalbuminuria. A simple test can detect abnormal amounts of albumin in the urine.
3. Race/ethnicity. Non-Hispanic whites have the highest risk, followed by non-Hispanic blacks. Mexican Americans have the lowest risk in this study.
4. C-Reactive Protein. This is an important biomarker of inflammation. A test result of 12.8 mg/dl was identified as the highest risk, while a result of 0.21 was the lowest risk. For testing information, see http://vrp.com/articles.aspx?ProdID=art2262&zTYPE=2
5. High blood pressure. This can be either a cause or a result of poor kidney function. Part of the kidney's job is to regulate blood volume, which is an important factor in blood pressure.
6. Diabetes. The risk of kidney disease increases with the length of time one has had diabetes.
7. Low income. As with many other health issues, low income inividuals are at higher risk because of poor access to health care.
8. Hospitalized in the past year. Whatever the cause for hospitalization, this was found to be a significant risk factor.
9. Periodontal status. Any stage of gum disease was found to be a risk factor, with patients who have lost all their teeth (edentulous) at high risk. The inflammatory response to periodontal (gum) disease is thought to be the reason for this association. See https://www.empowher.com/news/herarticle/2009/08/24/gum-disease-risk-kidney-failure-0
10. Low HDL cholesterol. The “good” HDL cholesterol was found to be more significant than total cholesterol, although high total cholesterol was also a risk factor.
According to this study, a non-Hispanic white over the age of 60 with high blood pressure, high C-reactive protein, and high albumin in the urine has a 72% probability of chronic kidney disease. Someone with all the risk factors has a 98% probability.
Chronic kidney disease can be managed with diet and medication. Be sure to get your annual check-ups, and talk to your doctor about your risks.
by Linda Fugate, Ph.D.
References:
1. Fisher MA, Taylor GW. “A prediction model for chronic kidney disease includes periodontal disease”, J Periodontol 2009 Jan;80(1):16-23.
2. Graves, JW. “Diagnosis and Management of Chronic Kidney Disease”, Mao Clin Proc. September 2008;83(9):1064-1069.