CDC Features

CDC Features

March 12 is World Kidney Day – Protect Your Kidneys

Kidneys play an integral role in a person's well-being, keeping the right amount of water in the body and helping to filter out harmful wastes. Common causes of kidney disease are diabetes and high blood pressure. The risk for kidney disease can be reduced by preventing these conditions when possible and managing them when present.

By keeping the right amount of water in the body and helping to filter out harmful wastes, kidneys play an integral role in a person's well-being.

Chronic kidney disease (CKD) is the loss of kidney function, resulting from physical injury or a disease that damages the kidneys, such as diabetes or high blood pressure. When the kidneys are damaged, it reduces their ability to remove wastes and extra water from the blood as well as they should. [1]

Photo: A man walking CKD is a silent condition. In the early stages, you will not notice any symptoms. CKD often develops so slowly that many people don't realize they're sick until the disease is advanced. [1] An estimated 26 million adults in the United States have CKD, but most do not know it. [2,3] CKD is the ninth leading cause of death in the United States and was responsible for the death of nearly 45,000 people in 2006. [4]

The final stage of CKD is end-stage renal disease (ESRD), which requires kidney dialysis (filtering of blood through a machine) or transplantation. In 2006, more than 100,000 people began treatment for ESRD and total Medicare expenditures for ESRD reached $23 billion, more than 6% of the entire Medicare budget. [5] By 2020, nearly 800,000 people are projected to be living on dialysis or with a kidney transplant. [5]

Causes of Kidney Disease

The most common causes of kidney disease are diabetes and high blood pressure.

Diabetes is a group of diseases characterized by high levels of blood sugar (also known as blood glucose). It results from insufficient production of insulin or the body's inability to use insulin properly.

In 2006, diabetes and high blood pressure accounted for 71% of the new cases of ESRD. [5] During 1988–1994, nearly 3 out of 4 persons who reported having diabetes also reported having high blood pressure. [6]

Ways to Prevent Kidney Disease

The risk for kidney disease can be reduced by preventing – when possible – diabetes and high blood pressure and managing these conditions when present.

High blood pressure can damage your kidneys. Individuals can check their blood pressure at their healthcare provider or at home to ensure it stays at a healthy level, generally considered to be lower than 130/80.

High blood sugar can also cause damage to the kidneys. People with diabetes should have their blood sugar levels checked (with what is known as an A1C test) at least twice a year, but ideally up to four times a year.

Helping to prevent diabetes, when possible, is another important step in preventing or minimizing the damage from kidney disease. Before being diagnosed with diabetes, some people have prediabetes, a condition that raises the risk of developing type 2 diabetes.

People with prediabetes have impaired fasting glucose (IFG), impaired glucose tolerance (IGT), or both—conditions where blood glucose levels are higher than normal but not high enough to be classified as diabetes. However, progression to diabetes among those with prediabetes is not inevitable.

Recent studies have shown that overweight people at higher risk for type 2 diabetes can prevent or delay the onset of the disease by losing 5 to 7 percent of their body weight, which can be achieved by eating healthier and getting 30 minutes of physical activity 5 days a week.

Infections – such as those affecting the bladder and kidney – can also damage your kidneys. Call your healthcare provider if you have any of these signs of bladder infection:

Cloudy or bloody urine
Pain or burning when you urinate
An urgent need to urinate often

Also, speak with your healthcare provider if you have any of these signs of kidney infections:

Back pain
Chills
Fever

CDC Addresses Kidney Disease

CDC has initiated the Chronic Kidney Disease Initiative, designed to provide public health strategies for promoting kidney health. To accomplish this goal, CDC has housed the Initiative within CDC's Division of Diabetes Translation and has taken a collaborative approach among entities within and outside the organization.

The Initiative has three primary objectives:

Develop capacity and infrastructure at CDC in the areas of kidney disease surveillance, epidemiology, health outcomes research, and health economics.
Award grants to support several state-based demonstration projects for CKD detection, prevention, and control.
Convene a consensus conference of kidney disease experts and other stakeholders to establish priorities and strategies in the public health approach to kidney disease prevention and control.

Among the key findings in the CDC CKD Surveillance Report:

In 1999-2006, among NHANES survey participants, <5% of those with kidney disease stages 1 or 2 (mild disease) reported being aware of having CKD; of those with CKD stage 3 (moderate disease), awareness was only 7.5%; for stage 4 (severe disease), awareness was still only less than half (40%).
Among those with CKD stage 3 or 4, younger (15%) and male (13%) participants and those who were non-Hispanic black (21%) had the greatest levels of awareness relative to their counterparts.
Awareness rates for CKD stage 3 or 4 were higher in those with comorbid diagnoses of diabetes and hypertension, but still quite low (20% and 12%, respectively).
Persons with CKD in the community are unlikely to be aware of their disease and seek appropriate treatment.

For more information, visit the Chronic Kidney Disease Initiative.

References

[1] http://kidney.niddk.nih.gov/kudiseases/pubs/chronickidneydiseases/
[2] Coresh J, Selvin E, Stevens LA, et al: Prevalence of chronic kidney disease in the United States. JAMA. 2007:298:2038–47.
[3] Plantinga LC, Boulware LE, Coresh J, et al. Patient awareness of chronic kidney disease: trends and predictors. Arch Intern Med.2008;168(20):2268–75.
[4] Heron MP, Hoyert DL, Xu J, Scott C, Tejada-Vera B. Deaths: Preliminary data for 2006. National vital statistics reports. Hyattsville, MD: National Center for Health Statistics. 2008;56(16):4–5.
[5] U.S. Renal Data System, USRDS 2008 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2008.
[6] Geiss LS, Rolka DB, Engelgau MM. Elevated blood pressure among U.S. adults with diabetes, 1988–1994. Am J Prev Med. 2002;22:43–9.