Chronic kidney disease as common as type 2 diabetes

Around six per cent of Stockholmers are thought to have chronic kidney disease, roughly as many as those suffering from type 2 diabetes. There is, however, a major difference between the two: chronic kidney disease is in many ways invisible, and most sufferers are unaware of the fact they have it. This according to researchers from Karolinska Institutet, who have studied the incidence of the disease amongst 1.3 million patients in Stockholm. The study is published in Nephrology Dialysis and Transplantation.

Sufferers of chronic kidney disease experience a gradual deterioration of kidney function. In its early stages, the symptoms are not that clear, although high blood pressure, anaemia and disruption of the calcium-phosphate balance are common. Eventually, the disease is associated with cardiovascular disease and death. Although in the later phases of the disease patients require dialysis or a kidney transplant to survive, if it is caught early enough there are good treatment options available. However, there is a serious lack of knowledge concerning diagnosis and treatment and how the patients are to be taken care of by the healthcare services.

When researchers at Karolinska Institutet analysed the results from clinical laboratories in Stockholm County, they noticed that around six per cent of the 1.3 million people examined had chronic kidney disease; however, most of them had not received a diagnosis and were unaware of their problem. Kidney disease turned out to be as common as type 2 diabetes and often has co-morbidity with other chronic diseases, such as hypertension, diabetes and cardiovascular disease.

“The study shows up a lack of awareness about how common the disease is,” says Juan-Jesus Carrero, researcher at the Department of Clinical Sciences, Intervention and Technology. “Caregivers need such knowledge to be able to treat and prevent serious, life-threatening kidney failure and to give the correct drug doses. There’s much room for improvement in the health services when it comes to detecting and treating the disease.”

The presence of albumin in the urine is a good measure of chronic kidney disease

Current guidelines say that the presence of albumin in the urine is a good measure of chronic kidney disease and enough to warrant referrals to a nephrologist. The study shows that many people with albumin in their urine were not referred or diagnosed with chronic kidney disease. Only one in four people with chronic kidney disease had seen a kidney specialist.

“By making caregivers more aware of the disease and how chronic kidney disease can be treated in its early phases, we’d make considerable heath gains for society,” claims Professor Carl-Gustaf Elinder, consultant for the Stockholm health administration and Peter Barany, acting clinical manager at Karolinska University Hospital, both of whom are co-authors of the study.

The study was financed with grants from the Stockholm County Council, the Swedish Heart and Lung Foundation, the Swedish Research Council, Dalarna University and the Martin Rind Foundation. It was conducted at Karolinska Institutet in collaboration with Johns Hopkins in the USA.

Publication

“Prevalence and recognition of CKD in Stockholm healthcare”
Alessandro Gasparini, Marie Evans, Josef Coresh, Morgan E. Grams, Olof Norin, Abdul R Qureshi, Björn Runesson, Peter Barany, Johan Ärnlöv, Tomas Jernberg, Björn Wettermark, Carl G Elinder and Juan-Jesus Carrero.
Nephrology Dialysis Transplant, online 13 oktober 2016, doi: 10.1093/ndt/gfw354