Screening for kidney disease essential in diabetes

Every patient with type 1 or type 2 diabetes should be screened annually for the presence of diabetic kidney disease, according to comprehensive guidelines developed by the National Kidney Foundation as part of its Kidney Disease Outcomes Quality Initiative.

The clinical practice guidelines offer “simple, clear messages about managing risk factors not only for kidney disease but also for cardiovascular disease, said at a meeting sponsored by the National Kidney Foundation.

The working group that drafted the guidelines included representatives of the American College of Physicians, the American Diabetes Association, and the American Heart Association, as well as the NKF. An estimated 21 million people in the United States have diabetes, and over half of them have kidney damage. The incidence of diabetic kidney disease is expected to double by the year 2030.

The guidelines recommend measurements of urinary albumin-to-creatinine ratio in a spot urine sample, and measurement of serum creatinine to estimate the glomerular filtration rate.

They recommended a spot urine sample rather than 24-hour urine collection so that this [measurement] can actually be done in an internist’s or other primary care provider’s office. Plus, it’s cheap, said by a medical and scientific director research at Providence Medical Research Center, Spokane, Washington.

Screening is essential because strategies that slow or prevent chronic kidney disease and its complications are available. “Simple, clear messages are very powerful. And that’s what we’re after.