eGFR, NKDEF/NIH, and kidney screening

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cured4real?
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Date Joined Dec 2005
Total Posts : 1944
   Posted 7/30/2009 10:42 AM (GMT -7)   
Hi-

Since many people here have kidney problems or are constantly screened, I thought it might be useful, also shows how changes made in our tests that radically impact lives. The eGFR is the test most docs run to make sure your kidneys are working.

Apparently the NIH NKDEF (national kidney disease education foundation) are eliminating Stage 1 & 2 screening ability from the eGFR tests, only reporting >=60 instead of reporting 60-89 as stage 1 & 2 (some mild dysfunction) and 90+ as normal or "high eGFR" disease. The NIH NKDEF is claiming the tests are "inaccurate" in healthy people and they assume everyone with an eGFR at or over 60 is healthy.  The results won't be reported on labs per the new standard, and Stanford points out that the eGFR will only be reported once someone already has some significant kidney disease (So much for screening and prevention), that the test has no use as an early screening tool when used this way, and that changes to take into account for race and age and body type/muscle mass/obesity were overlooked.

The proposal was in 2007 and may already be in effect, my Kidney Foundation screening had some notes and listed only the at or above 60, talk to your doc. the eGFR at or above 60 just tells me I don't have Stage three (just before end stage) moderately reduced kidney function.

NKDEF argues that elevated serum creatinine along with eGFR can be used for screening. According to Stanford labs, kidney damage can occur long before the creatinine is elevated in the blood.

The addresses for the articles are listed below. Since many of us also have kidney problems, its good to know when science gets dumbed down and stupider, supposedly to save money. You can see how the UK does it in the first link, how we used to do it through lab tests online, and how the NIH is saying it should be done in the second link, then stanford's argument in the third.  They are all short.

http://www.renal.org/pages/pages/other-info/ckd/ckd-stages.php

nkdep.nih.gov/resources/UACR_GFR_QuickReference_508.pdf

www.stanfordlab.com/images/PDF/2007August.pdf

 


Love, Marji
Ills--Sjogrens-Lupus cond., AI polygland. dysfunction 2, hyper/hypopigment, scoliosis,kyphosis,stenosis, deg.,O.A.,spine surgeries, salivary/lymphectomies, NASH, COPD, RLS, UT/GI bleeds, hystero, brain/nerve damage,TB
Meds--INH,Plaquenil, Evoxac, Metformin, Synthroid, HCTZ, HRT and Lidocaine patchs, Voltaren gel, Klonopin, Vicodin, Restasis, Albuterol, steroids


MJLD
Veteran Member


Date Joined Jul 2007
Total Posts : 1048
   Posted 7/30/2009 4:18 PM (GMT -7)   
Thanks for the info. Marj. Another factor for Lupus patients (and I guess other kidney patients also) is the renal biopsy. Judy

cured4real?
Veteran Member


Date Joined Dec 2005
Total Posts : 1944
   Posted 7/30/2009 7:15 PM (GMT -7)   
I'm afraid we are going to see lots of changes like this in the future, with our system more focused on crisis care and palliative care for the chronically ill rather than prevention and cures. This just totally slipped past, without patients or doctors having a say. The eGFR is much less invasive and can catch it early, before moderate and end stage, well it used to be able to before they decided to stop reporting any value over 60. What a waste.
Love, Marji
Ills--Sjogrens-Lupus cond., AI polygland. dysfunction 2, hyper/hypopigment, scoliosis,kyphosis,stenosis, deg.,O.A.,spine surgeries, salivary/lymphectomies, NASH, COPD, RLS, UT/GI bleeds, hystero, brain/nerve damage,TB
Meds--INH,Plaquenil, Evoxac, Metformin, Synthroid, HCTZ, HRT and Lidocaine patchs, Voltaren gel, Klonopin, Vicodin, Restasis, Albuterol, steroids

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