Kidney Disease Research Updates
CDC Releases CKD Fact Sheet, Plans Statistics WebsitePart of CDC’s CKD Initiative
In June 2010, the Centers for Disease Control and Prevention (CDC) and its partners released a chronic kidney disease (CKD) fact sheet to provide definitive information about the burden and consequences of CKD in the United States. The 4-page National Chronic Kidney Disease Fact Sheet is designed to be used and customized by federal agencies and voluntary health organizations to address different needs and target audiences. The fact sheet was developed with participation from other agencies within the U.S. Department of Health and Human Services, including the National Kidney Disease Education Program (NKDEP), and will be updated on a regular basis. The fact sheet can be viewed online at www.cdc.gov/diabetes/pubs/pdf/kidney_Factsheet.pdf (PDF, 251 KB) *.
The CDC is also developing a website for reporting statistics about the incidence and prevalence of CKD. The website prototype includes searchable information for the public, health professionals, and the media, along with downloadable graphics, data tables, and presentations. Preliminary feedback has been positive, and the website is expected to launch late this year or early in 2011.
The CKD Initiative
The fact sheet and website are only the latest products of the CDC’s CKD Initiative, led by Desmond Williams, M.D., Ph.D. Williams has enlisted the support of other units within the CDC to establish prevention strategies aimed at helping populations at risk for CKD maintain their kidney function and avoid end-stage renal disease requiring either dialysis or transplantation.
CKD prevalence has risen for the past 2 decades, despite the availability of effective treatments for slowing or stopping the decline of kidney function and avoiding CKD’s complications, such as cardiovascular disease, anemia, and bone disorders. Because CKD has no symptoms until the disease has advanced to almost total and permanent kidney failure, many people are unaware they have the condition. This lack of awareness means that people who could benefit from management strategies to prevent progression of their disease do not get the therapy they need. Williams noted, “The central premise of this initiative is that prevention of CKD is key.”
With a congressional mandate, the CDC established its CKD Initiative and convened an expert panel to identify goals and objectives to support its mission of CKD prevention. The 2-day meeting resulted in 10 recommendations for public health strategies designed to level out the steep rise in the number of people with CKD. A meeting report appeared in the March 2009 issue of the American Journal of Kidney Diseases.
The report includes recommendations for quality improvement measures in treating patients with CKD, increased surveillance of CKD incidence and prevalence, cost-effective screening procedures, materials for patient and provider education, improvement of laboratory procedures for reporting CKD, and increased public awareness of CKD.
The National CKD Surveillance System
The CKD Initiative has begun to implement projects that address several of the expert panel’s recommendations. Teams at the University of Michigan and The Johns Hopkins University were selected to work with the CDC in designing and implementing a national CKD surveillance system. The teams, consisting of epidemiologists, generalist and specialist clinicians, biostatisticians, and others, are helping the CDC list topics relevant to CKD surveillance and decide what to measure within each topic. Additional aims of the CDC CKD Surveillance System Project include
- learning from the experience of existing national and regional CKD data sources in order to identify and evaluate possible CKD topics to address, ways to measure conditions within those topics, and how to identify additional CKD indicators within a large population
- developing a comprehensive plan for integration of all the data source/topic-measure-indicator combinations into a functional national surveillance system
- conducting a pilot test of the system
- producing interim reports with recommendations for developing a national CKD surveillance system
The combined team identified six topics to address:
- burden of CKD—incidence and prevalence
- awareness of CKD
- risk factors for CKD
- health consequences of CKD
- processes and quality of care in CKD
- health system capacity for CKD
Two Interim Surveillance Reports
The CDC has published two interim surveillance reports on the prevalence of CKD in the general population and its impact on the health care system. Executive summaries are available on request to either of the two CDC CKD Surveillance System teams or the CDC.
Pilot Test of Screening Strategies
The CDC’s CKD Health Evaluation Risk Information Sharing (CHERISH) program is designed to test the feasibility of implementing a CKD detection/screening program at eight sites in four states. The program applied logistic regression analysis and classification tree analysis to identify the portion of the general population that would provide the best yield for screening. The researchers determined that screening people with diabetes or hypertension and those who are age 50 and older would render the most useful results. The CDC will conduct a follow-up survey and a health provider survey. The CDC has also completed a cost-effectiveness analysis that confirmed universal screening for CKD would not be practical or cost-effective. A complete report of this work is published in a March 2009 supplement to the American Journal of Kidney Diseases.
Partner agencies and organizations participating in the development of the National Chronic Kidney Disease Fact Sheet include the following:
- Agency for Healthcare Research and Quality
- Centers for Medicare & Medicaid Services
- U.S. Department of Veterans Affairs
- Health Resources and Services Administration
- Kidney Disease Interagency Coordinating Committee
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH)
- National Heart, Lung, and Blood Institute of the NIH
- American Society of Nephrology
- National Kidney Foundation
- United States Renal Data System
- University of Michigan Kidney Epidemiology and Cost Center
- University of California, San Francisco, and University of California, San Francisco Center for Vulnerable Populations
For more information, visit the CDC’s website at http://www.cdc.gov/diabetes/projects/kidney.htm.
NIH Publication No. 10-4531