Introduction

Chronic Kidney Disease affects approximately 15% of the American population, equating to nearly 37 million individuals. However, awareness of this condition is remarkably low, with 90% of those affected being unaware of their diagnosis. This paper aims to analyze the strategies for early detection and management of CKD, highlighting the role of primary care providers and the impact of new medical advancements.

Current Screening Practices

Presently, the standard approach in primary care is to screen for CKD in individuals with known risk factors, particularly diabetes and hypertension. Annual screenings are recommended for diabetic patients by the American Diabetes Association. The American Heart Association has introduced the concept of cardiovascular-kidney-metabolic (CKM) syndrome, emphasizing the need for regular monitoring in patients with a constellation of conditions including obesity, diabetes, CKD, and cardiovascular disease.

Challenges in Implementation

Despite the understanding of CKD's significance and the recommendations for screening, real-world application falls short. Sylvia Rosas, MD, an expert in nephrology, highlights the disparity in screening practices, particularly among insured diabetic and hypertensive patients.

Symptomatology and the Need for Early Detection

CKD often remains asymptomatic in its early stages, making early detection challenging yet crucial. Nisha Bansal, MD, points out that new hypertension, edema, and specific urine findings are key early indicators. Late diagnosis often results in the need for invasive treatments like dialysis or transplantation.

Debate on Universal Screening

The US Preventive Services Task Force (USPSTF) has historically been skeptical about the benefits of universal screening for CKD due to the lack of evidence suggesting that early detection alters disease progression. However, this view predates recent advancements in CKD treatment.

Advancements in CKD Treatment

Recent developments in medications, specifically SGLT2 inhibitors and mineralocorticoid receptor antagonists (MRAs), have shown significant promise in managing CKD. These drugs have changed the landscape of CKD treatment, making early detection more impactful.

Advocacy for Updated Screening Guidelines

In light of these advancements, there has been a push for the USPSTF to review and potentially update CKD screening recommendations. This effort is supported by findings from health policy researchers at Stanford University, who have demonstrated the cost-effectiveness and life-extending benefits of early CKD detection and treatment.

Conclusion

CKD remains a significant public health issue, with a vast majority of affected individuals being undiagnosed. The potential benefits of early detection, coupled with advancements in treatment, underscore the need for updated screening practices. A more proactive approach in primary care, driven by interdisciplinary collaboration and informed by recent medical advancements, could lead to improved outcomes for individuals at risk of CKD.

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Reference

Why Is Kidney Disease So Often Missed?

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‍About the Author

Rich Foreman brings over 30 years of technology leadership to his role of CEO and Co-Founder of KidneySoft.  As founding CTO, Rich led the team that developed the CordicoShield / CordicoFire Wellness App. Cordico was honored with the Sacramento Innovation Award in 2021. After achieving a 7 digit ARR, Cordico was acquired by Lexipol in 2020. Rich has a BS in Industrial Engineering from the University of Washington, an MPA from Troy State University and was an officer in the U.S. Navy. Rich co-authored his book, "Tap into the Mobile Economy." Rich's blog was listed in Top 20 Marketing Mobile Blogs of 2014. He has been featured on KCRA3, NEWS10, 1170 Tech AM PowerDrive, Business Radio Money 105.5, SiliconIndia, the Sacramento Business Journal, and the Sacramento Bee. Rich is also the Founding Director of the Sacramento Chapter of Startup Grind and served a term as Utility Commissioner for the City of Folsom. Rich is a regular contributor to TechWire.net and StartupSac. Rich was the Co-founder of Apptology which was named Small Business of the Year in 2014 by the Sacramento Asian Pacific Chamber. He was also the Founding Chief Technology Officer at Cordico. Cordico was acquired by Lexipol in 2020.  Rich also served 4 years as a Naval Officer in the Civil Engineer Corps.

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Patient Education Disclaimer

This material is for informational purposes only. It does not replace the advice or counsel of a doctor or health care professional. KidneyLuv makes every effort to provide information that is accurate and timely, but makes no guarantee in this regard. You should consult with, and rely only on the advice of, your physician or health care professional.

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