New Research Defines The Cardiovascular Risk Factors Associated With Chronic Kidney Disease (CKD)

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Screening kidney function in people with Carotid Artery Disease may help in the development of early intervention strategies (news source: research conducted by Life Line Screening and Imperial College London)

•CKD leads to thousands of premature deaths each year, diminishes quality of life for many people and represents a significant financial burden for the NHS.

•High blood pressure, Carotid Artery Disease and history of Stroke or Heart Disease double the CKD risk.

•Individuals with symptoms of Carotid Artery Disease were at 200% greater risk of CKD than those with no sign of Carotid Artery Disease.

New research presented at the Euro-Chapter of the International Union of Angiology (Rome, Sept, 2013) has identified the potential for screening early risk factors of chronic kidney disease1 (CKD). There are an estimated 45,000 premature deaths annually associated with the disease2.

The research, a collaboration between Imperial College London and Life Line Screening, collected data from nearly 3,000 Irish and British individuals who had self-selected for cardiovascular check-ups. Blood testing for Creatinine and eGFR (makers for Kidney function) was conducted alongside atherosclerotic carotid arterial disease using ultrasound techniques.

The mean age of the study group was 63.3. Although all considered themselves healthy, 10.5% of the females and 7.1% of the males were diagnosed with eGFR levels < 60, a predictable measure of CKD.

When blood marker readings were compared with a simple ultrasound examination of the carotid artery a clear correlation was established – individuals showing symptoms of carotid artery disease were at 200% greater risk of kidney disease than those with no sign of carotid artery disease.

“Preliminary results of our on-going research establishes the correlation between the presence of plaques in the arteries and the risk of chronic kidney disease,” said Dr John Coltart, Medical Director of Life Line Screening.

“CKD leads to thousands of premature deaths each year, diminishes quality of life for many people and represents a significant financial burden for the NHS. A relatively straight-forward blood test could detect risk of chronic kidney disease, a silent, and sadly under-diagnosed killer. It makes the case for the development of relatively simple new strategies for early detection of individuals at higher risk, such as those with carotid artery disease and disease management” said Dr Mohsen Chabok, Clinical Manager for Life Line Screening.

If identified early, patients with Mild or Moderate CKD could be monitored by their GPs without ever visiting a hospital. Patients could also take preventive actions by controlling their blood pressure and other risk factors such as Carotid artery disease.

CKD leads to a gradual loss of kidney function over time. The kidneys become less effective at filtering waste products from blood; water, waste and toxic substances therefore accumulate in the body. A minority of people with CKD suffer complete kidney failure, and require renal replacement therapy (RRT): dialysis or transplant. CKD also increases the risk of stroke, heart attack, bone disease and other conditions.

More than 1.8 million people in England have diagnosed chronic kidney disease (CKD), and a further million are estimated to be undiagnosed2.

The NHS in England spent an estimated £1.45 billion on CKD in 2009–10, equivalent to £1 in every £77 of NHS expenditure2.

ENDS

References:
1 Euro-Chapter of the International Union of Angiology, Sept 2013 - Association of vascular diseases with Chronic Kidney Disease in an asymptomatic population, Mohsen Chabok1,2, Farahmandfar Reza1,2, Aslam Mohammed1,Coltart John2 - 1Department of Surgery and Cancer, Imperial College London, 2Life Line Screening

2Chronic Kidney Disease in England: The Human and Financial Cost, NHS Kidney Care, 2012 (Insight Health Economics)

Background

Life Line Screening
Life Line Screening (LLS) is the UK’s largest provider of mobile preventive health screenings; bringing healthcare services to local people. It provides affordable, convenient, high-quality preventive health screenings for the early detection of stroke risk, cardiovascular diseases, type 2 diabetes and osteoporosis. It has amassed a database of screening results for over 8,000,000 individuals in UK and Ireland, US and Australia. LLS is committed to sharing this data anonymously with medical research centres across the world to develop new products, strategies and interventions in medicine.

Chronic Kidney Disease: Facts2
•The Quality and Outcomes Framework (QOF) register indicates that, in 2009–10, 4.3% of the population over the age of 18 in England had stages 3–5 CKD.

•CKD is classified in five stages, according to the level of kidney damage and function. The focus in this paper is on stages 3–5, which cover moderate to severe kidney disease. People with CKD are at greater risk of death than people of the same age and sex with healthy kidneys. The risk increases as the disease progresses, and is far greater than the risk of progression to RRT. It is estimated that there are 40,000–45,000 premature deaths each year in people with CKD. A large proportion of deaths in people with CKD are due to cardiovascular events such as strokes and heart attacks.

•There were an estimated 7,000 extra strokes and 12,000 extra myocardial infarctions (MIs) in people with CKD in 2009–2010, relative to the expected number in people of the same age and sex without CKD. The cost to the NHS of health care related to these strokes and MIs is estimated at £174–178 million.

•CKD leads to longer hospital stays than people of the same age without the condition, even when they go into hospital for treatments unrelated to CKD. The average length of stay is 35% longer for people with CKD, and that the cost to the NHS of excess hospital bed days for patients with CKD was £46 million in 2009–10.

•Infections such as meticillin (methicillin)-resistant Staphylococcus aureus (MRSA) are more common in people with CKD, in particular in those receiving haemodialysis. The risk of MRSA is more than 100 times greater in people receiving haemodialysis than in the general population. The cost to the NHS of MRSA in haemodialysis patients is estimated at £1.4 million.

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Paul Jarman
Life Line Screening
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