Don't-Wait-for-The-Importance-of-Early-CKD-Screening
The Benefits of Screening Everyone 35 and Older for Chronic Kidney Disease (CKD)
Chronic kidney disease (CKD) often goes undetected until it reaches an advanced stage. However, a recent study conducted by Stanford Medicine researchers reveals that implementing screening measures would not only increase life expectancy but also prove cost-effective. This article explores the potential advantages of screening all individuals aged 35 and older for CKD, highlighting the potential to save lives and reduce healthcare expenses.
The Prevalence of Chronic Kidney Disease:
Approximately 37 million Americans, or 15% of U.S. adults, suffer from chronic kidney disease, with diabetes and high blood pressure accounting for two-thirds of cases. The economic burden associated with CKD is significant, with annual Medicare spending reaching $87 billion, and an additional $37 billion spent on kidney replacement therapy each year.
The Importance of Early Detection:
Marika Cusick, lead author of the study and a Ph.D. candidate in health policy at Stanford Medicine, emphasizes the clinical silence of CKD until it progresses to late-stage kidney disease. This lack of awareness among individuals with early-stage CKD underscores the need for screening initiatives. By identifying and treating CKD at an earlier stage, the life expectancy of affected individuals can be improved, and the risk of progression to late-stage kidney disease, which is both life-threatening and expensive to treat, can be reduced.
Impact of SGLT2 Inhibitors:
The emergence of sodium-glucose cotransporter-2 inhibitors, a new class of drugs primarily used to treat Type 2 diabetes, has altered the discussion surrounding the effectiveness of screening for early-stage CKD. These drugs, approved by the Food and Drug Administration approximately ten years ago, have shown promise in slowing the progression of kidney disease.
The Screening Process:
Testing for albuminuria, or the presence of the particular protein albumin in the urine, is a component of CKD screening. Albuminuria serves as an indicator of kidney disease. To conduct their study, the Stanford Medicine researchers utilized data from the National Health and Nutrition Examination Survey, a nationally representative survey conducted by the National Center for Health Statistics. Extrapolating their findings to the entire U.S. adult population aged 35 years and older, the researchers performed a cost-effectiveness analysis of screening for albuminuria, with and without the use of SGLT2 inhibitors, in comparison to the current standard of care for CKD.
Positive Outcomes:
The study's authors assessed various factors, including costs, quality-adjusted life years, and incremental cost-effectiveness ratios. They discovered that implementing screening measures, in conjunction with the use of SGLT2 inhibitors, could potentially prevent the need for dialysis or kidney transplant in a significant number of individuals aged 35 to 75 years. The exact number of individuals saved from these interventions depends on the frequency of screening and ranges from 398,000 to 658,000 throughout their lifetime.
Cost-Effectiveness Considerations:
While the researchers found that incorporating a one-time screening with SGLT2 inhibitors would marginally increase lifetime healthcare costs for 55-year-olds, from $249,800 to $259,000, they firmly believe that the benefits outweigh the financial implications. Taking into account the expenses associated with treating chronic kidney disease and the resulting health improvements, the intervention is considered to provide good value for the money and resources invested.
Conclusion:
implementing comprehensive screening measures for chronic kidney disease in everyone aged 35 and older can significantly impact lives and healthcare costs. By proactively screening individuals, we can detect the disease early, improve life expectancy, and reduce the need for dialysis or kidney transplants. The inclusion of sodium-glucose cotransporter-2 inhibitors further enhances the potential to slow disease progression. While there may be a slight increase in healthcare costs, the long-term benefits outweigh the financial implications. Screening everyone for chronic kidney disease is a crucial step toward saving lives and addressing the challenges posed by this condition.
