Health Articles
Screening For Kidney Disease
The incidence of chronic kidney diseases has been increasing relentlessly for the past decade at an annual rate of about
6-8%. Chronic kidney disease is a major health problem resulting in considerably increased morbidity and mortality and decreased quality of life. The costs of treatment are very high and beyond the reach of many.
In recent years, the care for patients with kidney diseases has improved. However, the trend of late detection and late referrals has put patients at additional short and long term risk.
The need for early detection of kidney disease therefore becomes more important so that quality of life of these patients can be improved and the disease's progression slowed down as much as possible.
Who to screen for kidney disease?
Persons at increased risk of developing chronic kidney disease are those with :
- Hypertension
- Diabetes mellitus
- Age above 60 years
- Family history of kidney disease
- Recurrent urinary infections
- Urinary stones and
- Exposure to certain drugs particularly pain killers, antibiotics, heavy metals and chemicals
Screening Methods are listed below
Simple urine test for proteins, red blood cells, pus cells, white blood cells, bacteria and crystals.
If protein is positive in the urine, then a quantitative test for proteins (24 hour urine collection or protein to creatinine ratio in an un-timed spot urine sample) should be estimated.
If the urine sample is negative for protein by the usual tests, a specific search should be made for micro-albuminuria particularly in patients with diabetes or hypertension.
Blood test for urea, creatinine and creatinine clearance ultrasonography of the kidneys and urinary tract.
Further evaluation will depend upon the information obtained from these tests.
If initial screening is negative, it should be repeated every 6-12 months depending upon the risk factors. If screening is positive at any stage, the patient should preferably be referred to a nephrologist for a detailed diagnostic and therapeutic check-up.
To slow the progression of kidney disease, to prevent the consequences of chronic kidney disease and to decrease cardiovascular mortality associated with kidney disease, it is crucial to detect patients with kidney disease early and to optimize their care.
Dr. P K Prasher
M.D., D.M.,
Senior Consultant - Nephrology,
Fortis Hospital, Mohali.
|
