New guidelines for the management of chronic kidney disease will help doctors and patients recognise kidney failure earlier, experts said yesterday.
The Chronic Kidney Disease information pack has been developed by Irish kidney specialists and general practitioners and endorsed by their representative bodies. It introduces a more sensitive test for kidney problems which doctors said would also help reduce deaths from coronary heart disease.
Renal function has traditionally been assessed by measuring the blood levels of a substance called creatinine. However, this is not a sensitive way of diagnosing early kidney disease. The new guidelines recommend measuring the estimated glomerular filtration rate (eGFR), an estimate of how efficient the kidneys are in clearing waste products from the body.
"eGFR is much more sensitive at detecting chronic kidney disease [ CKD] than traditional methods such as creatinine," Dr Donal Reddan, one of the authors of the guidelines and a consultant nephrologist at University College and Merlin Park hospitals, Galway, said.
Asked what the change will mean for patients, he said the new guidelines would enable patients with CKD to be diagnosed and treated earlier. "The guidelines also include an international scoring system for CKD that makes it easier for patients to understand the condition."
It is estimated that CKD affects about 5 per cent of the population here. Some 1,400 people in the Republic receive kidney dialysis, with the number increasing at a rate of about 20 per cent annually. However, the majority of CKD patients do not go on to need dialysis and can be managed by their general practitioner.
"The most important thing about identifying CKD is that it identifies a population that may benefit from the aggressive management of cardiovascular risk factors," Dr Reddan said.
The importance of chronic kidney disease in patients with established cardiovascular disease was underlined in research presented at the Association of University Departments of General Practice in Ireland's (AUDGPI) annual meeting in Dublin last week.
Dr Liam Glynn and colleagues from the departments of general practice and medicine at the National University of Ireland, Galway found that, in people with heart problems, a reduction in kidney function was linked to a significant increase in deaths from coronary heart disease.
"People with CKD are much more likely to die of cardiovascular disease than to develop end-stage kidney failure, so it is imperative that we consider carefully cardiovascular risk in this group of patients and manage it aggressively," Dr Glynn told The Irish Times.
CKD is a "silent" disease that often goes undiagnosed in its early stages. It occurs in people with diabetes, high blood pressure as well as those with kidney problems.
Next Thursday, March 8th, is World Kidney Day.