New definition of chronic kidney disease labels 1 in 8 adults as sick

Risk of overdiagnosis warrants greater professional scrutiny and more public awareness, argue experts

2013-07-31

(Press-News.org) A new definition of chronic kidney disease labels over 1 in 8 adults and around half of people over 70 years of age as having the disease. Yet low rates of kidney failure suggest many of those diagnosed will never progress to severe disease.

On bmj.com today, Ray Moynihan and colleagues argue this is evidence of overdiagnosis. They call for a re-examination of the definition and urge clinicians to be cautious about labelling patients, particularly older people.

This article is the second of a series looking at the risks and harms of overdiagnosis in a range of common conditions. The series, together with the Preventing Overdiagnosis conference in September, are part of the BMJ's Too Much Medicine campaign to help tackle the threat to health and the waste of money caused by unnecessary care.

In 2002, a new framework for defining and classifying "chronic kidney disease" (CKD) was introduced. It defines chronic kidney disease as the presence of kidney damage or decreased kidney function for three months or more, irrespective of the cause, and is based largely on laboratory measures.

The framework has been widely embraced by many countries because it was assumed that earlier detection and treatment would slow progression towards kidney failure, and was updated in 2012.

But some doctors have raised concerns because the adoption of this definition has resulted in more than 1 in 8 adults (almost 14%) in the US being labelled as having chronic kidney disease and as many as 1 in 6 adults in Australia. Before the 2002 framework, it was estimated that 4.2 million Americans (1.7%) had chronic kidney disease.

In the UK, specialist referrals for chronic kidney disease are up 60% within a single NHS trust covering a population of 560,000 people, according to a University of Cardiff study, and up 40% at a hospital in Brisbane, Australia.

Advocates of the definition claim that "early detection can help prevent the progression of kidney disease." But despite the large numbers now labelled as having chronic kidney disease, low rates of kidney failure suggest many of those diagnosed will never progress to serious disease.

This say the authors, is evidence of overdiagnosis, and they point to the psychological effect of a disease label and the burden and costs of repeated assessment, testing, and potentially unnecessary treatment.

They argue that the benefits, harms, and costs of testing, monitoring, and treating the increased number of people being identified as having chronic kidney disease "need to be established by prospective studies."

They acknowledge that inferring overdiagnosis has limitations, but say the risk of overdiagnosis "warrants greater professional scrutiny and more public awareness" and they urge clinicians to be cautious about labelling patients, particularly older people.

"It is in everyone's interest to find the best way to maximise prevention of kidney disease and its consequences while minimising the risks and costs of overdiagnosis," they conclude.

### END

ELSE PRESS RELEASES FROM THIS DATE:

Aquatic playground can turn water tanks into fish schools

2013-07-31

Raising fish in tanks that contain hiding places and other obstacles can make the fish both smarter and improve their chances of survival when they are released into the wild, according to an international team of researchers. "It's a key problem in that we are very good at rearing fish, but we're really not very good at releasing those animals in the wild such that they survive," said Victoria Braithwaite, professor of fisheries and biology, Penn State. "There's a mismatch between the way we raise them and the real world." Juvenile Atlantic salmon raised in tanks ...

Controlling contagion by restricting mobility

2013-07-31

In an epidemic or a bioterrorist attack, the response of government officials could range from a drastic restriction of mobility — imposed isolation or total lockdown of a city — to moderate travel restrictions in some areas or simple suggestions that people remain at home. Deciding to institute any measure would require officials to weigh the costs and benefits of action, but at present there's little data to guide them on the question of how disease spreads through transportation networks. However, a new MIT study comparing contagion rates in two scenarios — with and ...

New approach to treating venomous snakebites could reduce global fatalities

2013-07-31

SAN FRANCISCO (July 30, 2013) – A team of researchers led by Dr. Matt Lewin of the California Academy of Sciences, in collaboration with the Department of Anesthesia at the University of California, San Francisco, has pioneered a novel approach to treating venomous snakebites—administering antiparalytics topically via a nasal spray. This new, needle-free treatment may dramatically reduce the number of global snakebite fatalities, currently estimated to be as high as 125,000 per year. The team demonstrated the success of the new treatment during a recent experiment conducted ...

Lawrence Livermore engineering team makes breakthrough in solar energy research

2013-07-31

LIVERMORE, Calif. – The use of plasmonic black metals could someday provide a pathway to more efficient photovoltaics (PV) --- the use of solar panels containing photovoltaic solar cells --- to improve solar energy harvesting, according to researchers at Lawrence Livermore National Laboratory (LLNL). The LLNL Materials Engineering Division (MED) research team has made breakthroughs experimenting with black metals. These nanostructured metals are designed to have low reflectivity and high absorption of visible and infrared light. The MED research team recently published ...

Myanmar at the crossroads: Conservationists see opportunities and challenges in biodiversity hotspot

2013-07-31

Long isolated by economic and political sanctions, Myanmar returns to the international community amid high expectations and challenges associated with protecting the country's great natural wealth from the impacts of economic growth and climate change. In a new study, scientists from the Wildlife Conservation Society have examined the implications of economic development and climatic changes on conserving Myanmar's biodiversity and provide recommendations for conservation planning within a context of a changing climate by strengthening the protected area system and ...

Rensselaer researchers identify cause of LED 'efficiency droop'

2013-07-31

Troy, N.Y. – Rensselaer Polytechnic Institute researchers have identified the mechanism behind a plague of LED light bulbs: a flaw called "efficiency droop" that causes LEDs to lose up to 20 percent of their efficiency as they are subjected to greater electrical currents. Efficiency droop, first reported in 1999, has been a key obstacle in the development of LED lighting for situations, like household lighting, that call for economical sources of versatile and bright light. In a paper recently published in Applied Physics Letters, the researchers identify a phenomena ...

Reprogramming patients' cells offers powerful new tool for studying, treating blood diseases

2013-07-31

First produced only in the past decade, human induced pluripotent stem cells (iPSCs) are capable of developing into many or even all human cell types. In new research, scientists reprogrammed skin cells from patients with rare blood disorders into iPSCs, highlighting the great promise of these cells in advancing understanding of those challenging diseases—and eventually in treating them. "The technology for generating these cells has been moving very quickly," said hematologist Mitchell J. Weiss, M.D., Ph.D., corresponding author of two recent studies led by The Children's ...

American Chemical Society podcast: Cotton is an eco-friendly way to clean up oil spills

2013-07-31

The latest episode in the American Chemical Society's (ACS') award-winning Global Challenges/Chemistry Solutions podcast series describes a report demonstrating that unprocessed, raw cotton has an amazing ability to sop up oil while also being eco-friendly. Based on a report by Seshadri Ramkumar, Ph.D., in the ACS journal Industrial & Engineering Chemistry Research, the new podcast is available without charge at iTunes and from http://www.acs.org/globalchallenges. In light of the 2010 Deepwater Horizon disaster, Ramkumar notes that a particular need exists for oil-spill ...

Cracking how life arose on earth may help clarify where else it might exist

2013-07-31

Does life exist elsewhere or is our planet unique, making us truly alone in the universe? Much of the work carried out by NASA, together with other research institutions, is aimed at trying to come to grips with this question. A novel and potentially testable theory of how life arose on earth, first advanced more than 25 years ago by Michael Russell, a research scientist in Planetary Chemistry and Astrobiology at the NASA Jet Propulsion Laboratory, was further developed in a recent paper published in Philosophical Transactions of the Royal Society B (PTRSL-B)—the world's ...

Study finds evidence of nerve damage in around half of fibromyalgia patients

2013-07-31

About half of a small group of patients with fibromyalgia – a common syndrome that causes chronic pain and other symptoms – was found to have damage to nerve fibers in their skin and other evidence of a disease called small-fiber polyneuropathy (SFPN). Unlike fibromyalgia, which has had no known causes and few effective treatments, SFPN has a clear pathology and is known to be caused by specific medical conditions, some of which can be treated and sometimes cured. The study from Massachusetts General Hospital (MGH) researchers will appear in the journal Pain and has been ...

Authoritative parenting styles are associated with better mental health and self-esteem among adolescents, while authoritarian parenting styles are associated with depression and lower self-esteem and

A rose by any other name? Not necessarily—how words sound aesthetically correlates with their memorability, study finds

The odds of iron deficiency in adolescent girls are almost 14 times higher among those who experience heavy menstruation and follow a meat-restricted diet, compared to girls with normal menstruation w

Robert Wood Johnson University Hospital and Rutgers Robert Wood Johnson Medical School receive National Rare Disease Center of Excellence recognition

The Mohn Prize for 2026 awarded to Canadian John Smol

[Press-News.org] New definition of chronic kidney disease labels 1 in 8 adults as sick
Risk of overdiagnosis warrants greater professional scrutiny and more public awareness, argue experts

New definition of chronic kidney disease labels 1 in 8 adults as sick

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: