Up to half of people living with potentially deadly kidney disease don’t know they have it, a new review suggests.
About one in seven Americans – 37 million – are diagnosed with chronic kidney disease (CKD), meaning their kidneys cannot properly filter waste out of the blood, causing it to build up in the body.
This causes dangerously high blood pressure and levels of chemicals like potassium, which can trigger irregular heart rhythms and raise the risk of deadly heart attacks and strokes.
People with CKD also have to undergo months or years of dialysis – which artificially filters waste out of the blood – until they can have a kidney transplant.
CKD is the ninth leading cause of death in the US, killing 55,000 Americans every year.
Early detection is key for protecting kidney function and avoiding a transplant. However, a new review found up to 50 percent of cases of CKD in high-income countries like the US and UK go undiagnosed until they reach later, harder-to-treat stages.
The findings also showed minority populations and women were up to twice as likely as white men to go undiagnosed with CKD.
And of those with a CKD diagnosis in their medical records, nine in 10 were still unaware they had the condition.
Researchers estimate up to half of chronic kidney disease cases in high-income countries like the US go undiagnosed, increasing the risk of patients needing dialysis (pictured above) and transplants
‘Chronic kidney disease remains one of the most concerning conditions currently impacting global health,’ Dr Jennifer Lees, study author and senior clinical research fellow at the University of Glasgow, said.
‘The overriding message from our series of research papers is that there remains a pressing need for attention and resource to be focused on this condition.’
She also urged doctors to regularly perform urine tests in people at risk of CKD, as damaged kidneys produce excess proteins that show up in the urine.
‘There is huge potential to improve early diagnosis, treatment and healthy lifespan by testing urine for protein routinely across a range of health care settings,’ she said.
‘This may be particularly important in those most at risk of underdiagnosis, including non-white populations and women.’
There is no single cause of CKD, but it’s often triggered by other conditions like diabetes and high blood pressure, which damage tiny blood vessels in the kidneys, making them less effective at filtering out waste.
The disease strikes 844 million adults worldwide, and researchers behind the new study estimate CKD will become the world’s fifth leading cause of death by 2040.
The review, published in The Lancet, examined recent studies on CKD and methods of diagnosing and screening for the condition, which include blood and urine tests, as well as ultrasound imaging and biopsies of the kidneys.
They estimate that about 30 to 50 percent of CKD cases in high-income countries, such as the US, are not diagnosed by a doctor.
And non-white adults and women were particularly prone to being undiagnosed. The National Kidney Foundation estimates black adults are 47 percent more likely to have CKD than the overall US population, while American women are at a 30 percent increased risk.
The researchers estimated minority populations are about twice as likely as white men to have their CKD go undetected.
The early signs of chronic kidney disease are subtle, often including back pain, puffiness around the eyes and increased urination
The lack of detection may be due to early stage CKD often causing few to no symptoms, earning it the nickname of a ‘silent disease.’
However, patients in the early stages may find themselves needing to urinate more often, as well as foam or frothiness in the urine, which is a sign of the protein albumin leaking into the urine.
Other early signs include puffiness around the eyes due to large amounts of albumin in the urine, as this protein usually acts as a sponge to keep fluid inside the blood vessels.
Patients may also experience swelling in the ankles and feet, as kidney disease causes the body to retain more sodium, which pools into the lower extremities.
As the condition progresses, CKD leads to severe fatigue, nausea and urinating less often, as the kidneys’ filtering units, called nephrons, become scarred, causing issues producing and releasing urine.
CKD may also cause a dull ache in the back, under the ribs and above the hip.
‘Governments need to prioritize resourcing health services to diagnose at-risk patients, such as those with heart disease, high blood pressure, or diabetes, earlier, and deliver urgent, preventative care, or millions of patients and economies worldwide will suffer the consequences,’ Alison Railton, director of policy at Kidney Research UK, said.