The Quick Pace of Kidney Disease

Screening chronic kidney disease patients may be cost effective way to prevent kidney failure

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Kidney disease affects people of all ethnicities. However, the disease may take its toll more quickly in patients of certain races.

Researchers found that chronic kidney disease may worsen more quickly in African Americans than in other races.

They also found that screening African Americans for a certain marker of kidney disease could save tens of thousands of dollars.

"See a doctor regularly if you have kidney disease."

While African Americans have a similar rate of chronic kidney disease as other Americans, they have a higher risk of progressing to kidney failure - a condition that requires dialysis or a kidney transplant. While the lifetime rate of kidney failure is about 8.6 percent among African Americans, it is about 3.5 percent for other Americans.

Thomas Hoerger, PhD, of the non-profit research group RTI International, and colleagues wanted to see if common kidney disease risk factors - such as diabetes and high blood pressure - could explain why African Americans have a higher lifetime rate of kidney failure.

They found that these risk factors did not fully explain the higher rates of kidney failure among African Americans. Rather, African Americans may have higher rates of kidney failure because kidney disease gets worse faster in these patients.

The researchers then asked if screening for a certain marker of chronic kidney disease - called microalbuminuria, or leakage of small amounts of protein in the urine - would be a cost effective approach to preventing kidney failure.

The idea is that screening could lead to earlier treatment that protects against kidney failure.

In 2009, more than 571,000 American adults were affected by kidney failure, at a cost of more than $42 billion.

The study's results showed that screening followed by drug treatment of African Americans with kidney disease was very cost effective.

"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 (high blood pressure)," said Dr. Hoerger.

Compared to usual care, screening African Americans at:

  • 10-year intervals had a cost-effectiveness ratio of about $9,000 per quality-adjusted life year
  • 5-year intervals had a cost-effectiveness ratio of about $11,000 per quality-adjusted life year
  • 2-year intervals had a cost-effectiveness ratio of about $19,000 per quality-adjusted life year
  • 1-year intervals had a cost-effectiveness ratio of about $35,000 per quality-adjusted life year

A cost-effectiveness ratio is the comparison of the cost of an intervention - in this case, screening - to the cost of the intervention's effect.

The cost effectiveness for the same screening intervals was higher among non-African Americans:

  • $17,000 per quality-adjusted life year at 10-year intervals
  • $23,000 per quality-adjusted life year at 5-year intervals
  • $44,000 per quality-adjusted life year at 2-year intervals
  • $81,000 per quality-adjusted life year at 1-year intervals

This research was funded by the Centers for Disease Control and Prevention.

The authors reported no financial disclosures.

The study was published November 30 in the Journal of the American Society of Nephrology.

Reviewed by: 
Review Date: 
November 29, 2012
Last Updated:
February 26, 2013