Presence of kidney disease is a common and underappreciated pre-e

Presence of kidney disease is a common and underappreciated pre-existing medical cause of resistant hypertension [1]. Therefore, treatment

of hypertension has become the most important intervention in the management of all forms of chronic kidney disease (CKD). For this reason, the forthcoming World Kidney Day (WKD) on 12 March 2009 will emphasize the role of hypertension for renal disease. How does one recognize the presence of chronic kidney disease? In contrast to a decade ago, today most laboratories around the world report estimated glomerular filtration rate (eGFR) instead of or in addition to serum creatinine. This now provides the physician with information about kidney function that is, in general, more informative. As a result, a greater percentage of patients with diabetes or hypertension and their physicians have a better knowledge of their Geneticin solubility dmso kidney function. Assessment of eGFR as an index of kidney function should be complemented by assessing urine for protein or albumin (preferred). In spite of these laboratory updates, recent data demonstrate that a given patient’s knowledge that he or she has CKD is very low. In

a recent analysis of almost half a million People in Taiwan who took part in AG-881 datasheet a standard medical screening program, 12% had CKD [2]. It was noteworthy that less than 4% of those with CKD were aware of their condition. People with CKD are several times more likely to die from cardiovascular (CV) causes than those without CKD; thus, hypertension is a major risk factor in this context [3]. The combination of CKD and hypertension, therefore, is a major public health issue; because of the costly treatments necessary for end-stage renal disease (ESRD), end-stage CKD has also become a substantial burden to health budgets. What is the worldwide frequency of chronic kidney disease? The frequency of CKD continues to increase worldwide, as does the prevalence of end-stage renal disease (ESRD) [4, 5]. The most common, but not only, causes of CKD are hypertension IKBKE and diabetes. The presence

of CKD is associated with a large increase in cardiovascular (CV) risk. Moreover, CV risk increases proportionally as eGFR falls below 60 ml/min. Lastly, death from CV causes is higher in CKD and much higher than is cancer in CKD; as a result, the identification and reduction of CKD have become public health priorities [6]. The reported prevalence of CKD stages 1–4 in the most recent NHANES (national health and nutrition examination survey) between 1999 and 2006 was 26 million out of a population base of approximately 200 million. This represented United States residents aged 20 and older adult; of these, 65.3% had CKD stage 3 or 4. Those with diabetes and hypertension had far greater prevalence of CKD (37 and 26%, respectively) compared to those without these conditions (11 and 8%, respectively) [7].

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