It is well known that African Americans have a similar prevalence of CKD as other Americans, but they are more likely to progress to kidney failure. The lifetime incidence of kidney failure is about 8.6% for African Americans compared with 3.5% for other Americans. The reasons for this disparity are not known.
To investigate, Thomas Hoerger, PhD (RTI International) and his colleagues used a simulation model of CKD progression to see if the prevalence of common CKD risk factors (such as high blood pressure and diabetes) could explain the higher lifetime incidence of kidney failure among African Americans.
The researchers found that the higher lifetime incidence of kidney failure among African Americans was not fully explained by the prevalence of common CKD risk factors. Instead, it could be explained by faster progression of CKD among African Americans during the later stages of the disease.
The investigators then considered whether screening for a particular marker of CKD called microalbuminuria-when the kidneys leak small amounts of protein into the urine-would be cost-effective. (Screening could lead to earlier treatment that might prevent kidney failure.) "We found that screening for microalbuminuria is cost-effective for African Americans at either five- or 10-year intervals, particularly for those with diabetes or hypertension," said Dr. Hoerger.
Kidney failure affected more than 571,000 US adults and cost more than $42 billion in 2009.
Study co-authors include John Wittenborn, Xiaohui Zhuo, PhD, Meda Pavkov, MD, PhD, Nilka Burrows, Paul Eggers, PhD, Regina Jordan, Sharon Saydah, PhD, and Desmond Williams, MD, PhD.
Disclosures: This research was supported by funding from the Centers for Disease Control and Prevention. The findings and conclusions are those of the authors and do not necessarily represent the official position of the CDC. The authors reported no other financial disclosures.
The article, entitled "Cost-Effectiveness of Screening for Microalbuminuria among African Americans," will appear online at http://jasn.asnjournals.org/ on November 29, 2012, doi: 10.1681/ASN.2012040347.
The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.
Founded in 1966, and with more than 13,500 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.