chronic kidney disease

Chronic kidney disease is a major concern for healthcare providers worldwide. Tests that allow efficient and accurate diagnosis are vital. We all know someone living with chronic kidney disease (CKD) – even if they have not yet been diagnosed: it is estimated that 10 percent of the global population is affected by CKD 1 . Between 1990 and 2010, kidney disease became one of the fastest-growing causes of death in the world, second only to HIV/AIDS. 1 Reviewing the data on CKD diagnosis, we were struck by how timely detection can impact patient outcomes. Catching kidney disease in the early stages is a challenge, since there are typically no overt signs or symptoms. However, if CKD is detected early and managed appropriately, the deterioration in kidney function can be slowed and the risk of associated cardiovascular complications reduced. 2 For patients, this can make all the difference, but we know too that there is a real impact for health systems where demand is rising and resources may be scarce. CKD also represents more than €1 trillion in healthcare costs over the next decade. 3 Key indicators of kidney function So, what are the tell-tale signs of kidney problems? The presence of increased amounts of protein (albumin) in urine, or microalbuminuria, is a key indicator of kidney function and is routinely used to monitor the health of patients with diabetes mellitus. There are a number of tests available for urine creatinine estimation, the majority of which involve chemical or enzymatic reactions. When it comes to routine screening in a point-of-care setting, we believe the best available option is urine ACR. Like CKD, the prevalence of diabetes is increasing worldwide, with 422 million cases as of 2014. 4 A simultaneous creatinine measurement permits normalization of albumin concentration and requires only a single...
A new report on Laboratory Medicine in Poland highlights the role of laboratory diagnostics in the timely treatment of chronic conditions. Not only can investment in early diagnosis save and improve lives, it can also save money on long-term care. ‘There is not enough data on how health budgets are spent,’ says Jozef Jakubiec, Director General of IPDDL which compiled the report with Deloitte. ‘We wanted to show hard evidence to illustrate to decision-makers that that situation in Poland is considerably worse than in neighbouring countries, such as the Czech Republic.’ Take diabetes, for example. Serious complications from the advanced stages of the condition can include chronic kidney disease (CKD). This, in turn, may lead to a life-long dialysis or kidney transplantation – both of which come at a considerable personal and economic cost. Some people live with diabetes mellitus without symptoms for many years. Indeed, it may not be until complications arise that their condition is diagnosed. However, by that stage considerable damage may have been done. Even small changes in blood glucose can begin the process of degeneration of blood vessels. In order to intervene early and with the right treatment, glucose testing is essential. If Poland were to increase glucose testing by 25% a year, savings of PLN 0.5 billion (€0.12 billion) would be made within six years. For patients with diabetes-related conditions, the annual cost was estimated at PLN 5 (€1.17) in pre-diabetes compared to PLN 9,269 (€2,168) in diabetes with complications (an over 1800-fold difference). ‘The earlier the treatment is taken and monitored regularly, the more effective and less expensive it is,’ the report says. Prevention is cheaper than cure For CKD, it’s a similar story: the disease may remain asymptomatic until the last stage of renal failure. ‘There’s a big shift towards CKD because...