Quest Diagnostics, the world's leading provider of diagnostic information services, announced its support of the updated global version of the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) Chronic Kidney Disease (CKD) guideline recently released by Kidney Disease: Improving Global Outcomes (KDIGO). World Kidney Day aims to raise awareness of the important role kidneys play in overall health and to reduce the frequency and impact of kidney disease and its associated health problems worldwide.
The updated guideline expands the CKD classification system to include albuminuria, protein in the urine, as well as "cause of disease" and glomerular filtration rate (GFR) stage. These changes provide a more accurate view of each patient's condition to help physicians stratify risk which can help lead to improved management and treatment.
"We applaud the National Kidney Foundation for its leadership in educating patients and physicians on kidney disease risk and prevention," said Harvey W. Kaufman, senior corporate medical director, Quest Diagnostics, and co-author of a 2011 study published in the peer-reviewed online journal PLoS ONE, which found that 89 per cent of those found to be at high risk for CKD through their employer's lab-based wellness programme were unaware of the health concern. "The updated guideline incorporates a better understanding of the factors that contribute to the progression of kidney functional impairment and are easier for primary care physicians to understand and follow so they can better identify patients with early stages of CKD and take steps to treat common underlying conditions, preserve remaining kidney function, and adjust medication that is dependent upon kidney function for elimination."
Approximately 26 million Americans suffer from CKD, a condition characterized by the gradual loss of kidney function. Though often thought of as an older person's disease, CKD's prevalence has grown among younger adults, largely because the most important risk factors, diabetes and hypertension (high blood pressure), have both grown rapidly among younger adults due to the increases in obesity and other factors related to these conditions. Chronic kidney disease is important to identify at an early stage when the progression can be slowed or stopped before the kidneys have failed and people affected are placed on dialysis and need a kidney transplant. At its earliest stages, CKD is generally silent and only detected through laboratory tests. Watch Quest Diagnostics short "Intro to Chronic Kidney Disease" video to learn more about how CKD impacts health.
"The new staging predicts meaningful outcomes for patients more accurately based on both blood and urine tests instead of one or the other test alone," said Joseph Vassalotti, chief medical officer, National Kidney Foundation. "When you put together a patient's level of kidney function as assessed by the blood test to estimate glomerular filtration rate (eGFR) and the extent of kidney damage based on urine albumin level, you improve prediction of risk for future chronic kidney failure and subsequent cardiovascular events."
In Quest Diagnostics data of nearly 2.5 million patient encounters in which patients were tested simultaneously for serum creatinine for eGFR and urinary albumin, many patients had CKD and many were classified differently using the combination of eGFR and urinary albumin than if only eGFR was considered. Among patients who were initially considered to have mild CKD based on eGFR of 45-59, ml/min/1.73m2, 69.0% were classified as moderately increased risk, 23.2% were classified as high risk, and 7.8% were classified as very high risk.
"Our data support the new guideline and suggest that many patients who may have been considered to have mild CKD based on eGFR alone really have moderate to severe progressive CKD when urinary albumin status is simultaneously evaluated," said Dr Kaufman. "We expect the new guideline to be a useful tool to help physicians identify, manage, and treat patients with CKD."
Quest Diagnostics, a strong supporter of the recommended testing for CKD as described in the original NKF-KDOQI guidelines, was among the first laboratories to provide estimated glomerular filtration rate (eGFR) calculation along with all requests for serum creatinine. The company was also one of the first laboratories to update the basis of the equation to the CKD-EPI equation that is now recommended in the new guideline. Quest Diagnostics provides a wide spectrum of testing to support the needs of nephrologists and other physicians who are involved in classifying and managing patients with kidney disease.
The National Kidney Foundation is the leading organization in the US dedicated to the awareness, prevention and treatment of kidney disease for hundreds of thousands of healthcare professionals, millions of patients and their families and tens of millions of Americans at risk.