They are not something most of us think about, that is, until something goes wrong. They filter 53 gallons of blood per day, remove toxins and excess volume from your blood, and help control other things like blood pressure and hemoglobin counts. They are our kidneys: two fist-sized bean-shaped organs that keep you healthy by making sure your blood remains in metabolic balance. Once a patient approaches kidney failure, we hope to get them a kidney transplant, but the reality is that the majority of patients undergo dialysis simply because there are not enough donated kidneys to go around. Either dialysis or a kidney transplant is needed to survive once kidney function is so poor that it needs replacement therapy.
An estimated 33 percent of American adults are at risk for developing kidney disease, including people who have diabetes, high blood pressure, and possibly those who are overweight. Chronic kidney disease (CKD) patients often remain asymptomatic, so those afflicted won’t know they have it until these vital organs reach a later stage of dysfunction. Unfortunately, the lack of proper screening for CKD contributes to the high rates of unawareness among CKD patients themselves. Additionally, the most common cause of morbidity and mortality in CKD patients is cardiovascular disease, another reason to highlight the critical need for diagnosing CKD patients early on.
National Kidney Month is observed every March, a time dedicated to raising awareness about the risks of kidney disease and to encourage screening, prevention and good health habits. Similar observations take place in many other countries.
This year, LabCorp is continuing to partner with the National Kidney Foundation (NKF), this time on its new public awareness campaign called “Are You the 33%?”, which focuses on the one-third of American adults at risk for developing CKD. By taking a simple 60-second Kidney Risk Quiz, you can learn if you are at risk and what you can do about it, starting by talking with your doctor. If you are at risk, two simple tests are combined into one, known as the Kidney Panel, which measures serum creatinine and protein in the urine. LabCorp supported the roll out of the Kidney Panel several years ago to raise awareness and the ability to detect CKD earlier. It’s easy to get tested and the results can have a profound impact on your care and management.
I am an adult nephrologist who still cares for CKD patients as an adjunct professor at the University of North Carolina. I joined Covance in 2017 as the Nephrology Therapeutic Area head. I also serve on the Board of Directors for the Kidney Health Initiative, working to promote innovation and patient-focused drug development for people living with kidney disease.
For me, CKD is personal. Two of my cousins were diagnosed with end-stage kidney disease at ages 40 and 42, and their experiences demonstrate that there is so much more work to do.
Kidney disease claims more lives than breast and prostate cancer combined, yet it is an under-recognized epidemic. Last year the Trump administration signed an executive order that will direct Medicare to develop payment models that encourage preventative kidney care, and increase the use of transplantation and home dialysis. Specifically, three of the major goals are to reduce the number of Americans developing kidney failure by 25 percent, double the number of kidneys available for transplant by 2030, and ensure that 80 percent of new patients with kidney failure receive a transplant or home dialysis by 2025.
Also last year, the U.S. FDA approved the first novel treatment for diabetic kidney disease (DKD) in nearly 18 years: canagliflozin, an SGLT-2 Inhibitor. In addition to ongoing studies for DKD, there are more trials than ever across the different etiologies of CKD, including the investigation of new agents for glomerular disease, which includes focal segmental glomerulosclerosis, or FSGS, and immunoglobulin A nephropathy, commonly known as IgAN.
LabCorp has partnered with the NKF and other organizations on removing barriers to testing, helping to standardize tests used to detect CKD, improve comparison of test results between laboratories, increase early recognition and promote patient awareness. Diagnostics also offers a guideline-based clinical decision support program to assist providers, as well as patient education materials to help improve patient awareness and understanding of this disease.
I recently had the pleasure of collaborating with my LabCorp colleagues on an analysis of patients who had been tested at a LabCorp facility between January 2013 and December 2019. The study looked at data from more than 28 million patients to evaluate the frequency of guideline-recommended kidney-disease screening among at-risk patients. To our knowledge, this is the largest retrospective analysis of kidney disease screening rates in the United States.
The results were sobering. We found that only 17.4 percent of at-risk individuals had an adequate screening for chronic kidney disease throughout the time frame of our research. This data highlights the need for improved strategies for screening and detection as well as the need to improve both patient and physician awareness. This work will be shared as a poster at the annual NKF Spring Clinical Meeting – now being held virtually but the poster will be published in the American Journal of Kidney Disease – and we are further collaborating with the NKF on future publications as well as efforts to increase CKD patient enrollment into renal trials. The NKF is launching the first national CKD registry of patients, and as a Steering Committee member I hope to execute on our common goal of increasing awareness and participation of patients in CKD trials.
We are committed to enhancing detection and investigating new treatments that will ultimately be placed into the hands of our CKD patients. Our clinical laboratory database is providing is invaluable insights into clinical trial design and patient recruitment strategies.
If you take the quiz and find that you are one of the 33 percent, visit your doctor and request that they perform urine and serum creatinine tests. And if you’re not among the 33 percent, consider signing an organ donation card. It’s one of the best things you can do to improve the outlook for people living with kidney disease.