Chronic Kidney Disease Incidence Grows While Awareness Among Those Most At Risk Lags

DEERFIELD, Ill., March 5, 2009 — People who have chronic kidney disease (CKD) may have no symptoms to alert them of the deadly condition, yet even among those who are most at risk, kidney health awareness and screening are alarmingly low. The incidence of CKD is growing, fueled largely by diseases associated with an aging population, hypertension and increasing rates of diabetes largely related to obesity. Approximately 400 to 600 million adults worldwide have CKD.¹ In the United States, 26 million adults have CKD and millions of others are at increased risk.² As the global incidence continues to rise, public health costs may become overwhelming, making detection, prevention and cost-effective treatment options increasingly important.

“If there is any chance you may be at risk, talk to your doctor about the screening process,” says Sarah Prichard, MD, vice president of global clinical affairs for Baxter’s Renal business. “The screening process is simple, and early detection can dramatically affect what options you have, how long you can preserve kidney function and the quality of life you will experience while living with the disease.”

Baxter International Inc. encourages people around the world to consider their risk and undergo screening on World Kidney Day, March 12. World Kidney Day is an initiative of The International Society of Nephrology (ISN) and the International Federation of Kidney Foundations (IFKF) aimed to raise awareness about the heavy burden of CKD on human lives. People over the age of 60 and people with diabetes, hypertension or a family history of kidney disease are at a higher risk of CKD and should undergo screening regardless of if they display symptoms. Other at-risk groups include Hispanics, Asians, Pacific Islanders, as well as African-Americans and Native Americans who may be as much as four times more likely to develop the disease.³ CKD screening is conducted through a blood or urine test that takes a few minutes.

As kidney disease progresses, people’s kidneys work less and less effectively. If the disease is detected early, lifestyle modifications and selected medications can preserve kidney function for a longer period of time. If the disease progresses, people living with kidney disease must depend on renal replacement therapies, usually in the form of dialysis, or transplantation to make up for lost kidney function in order to survive. Patients can choose to receive dialysis treatment at home or in a dialysis center or hospital.

When kidney disease progresses to end-stage renal disease (ESRD), transplantation is usually the preferred option. When transplantation is not possible, dialysis options include:

• Center- or Hospital-Based Traditional Hemodialysis (HD): HD removes wastes and fluid from the blood by using a machine and a dialyzer, also known as an artificial kidney. Blood is first removed from the body, then cleaned and returned back to the body with the help of the dialyzer. A typical HD schedule is a four-hour session, administered three-times weekly, at a hospital or clinic.
• Dialysis in the Home:
  • Peritoneal Dialysis (PD): Home dialysis is widely used today, predominantly in the form of PD. PD works inside the body, using the peritoneal membrane, or abdominal lining, as a natural filter to remove waste from the bloodstream. In this form of dialysis, blood never leaves the body. Dialysis fluid enters the peritoneal cavity through a small, plastic tube, called a catheter, surgically inserted in the abdomen. Extra fluid and waste travels across the peritoneal membrane into the dialysis fluid, which is then drained from the abdomen. PD generally provides continuous dialysis, 24 hours-a-day. There are two types of PD therapy, automated peritoneal dialysis (APD), primarily performed by a machine while a patient sleeps; and continuous ambulatory peritoneal dialysis (CAPD), that is performed manually by the patient. Some studies have indicated that PD is associated with equal or better survival in many patients than the in-center alternative,⁴ as well as high levels of patient satisfaction and personal well-being.⁵ Home dialysis offers more time for family and social activities and, additionally, is associated with continued employment.⁶
  • Home Hemodialysis (HHD): HHD presents an additional home-based treatment option for people living with kidney disease. HHD is a form of HD using a device modified for the home. It can be done at night while the patient is asleep, or during the day. It typically is done three to six times a week. The length of the dialysis varies. If done during the night (nocturnal HD), it can last as long as the patient wants to sleep, anywhere from five to eight hours. If done during the day (short daily HD), the treatments are usually from two to four hours.

Currently, 98 percent of patients were considered medically eligible for HD, 87 percent of patients were assessed as medically eligible for PD and 54 percent of patients were judged medically eligible for transplant.⁷ Research indicating the benefits of nocturnal and daily dialysis has received  attention from many nephrologists and encouraged them to expand their home therapy practice. People living with kidney disease and their families should talk with their doctor to understand which dialysis therapy best suits their condition and lifestyle.

“Multiple studies have demonstrated people living with kidney disease who are informed about treatment options and given a choice more often choose home therapies than do uninformed patients,” says Prichard. “We need to do a better job of ensuring that those who are eligible for multiple kinds of treatment are informed of options that may better suit their condition or lifestyle.”

For more information talk to your physician or visit www.renalinfo.com.

About Baxter

Baxter International Inc. (NYSE:BAX) develops, manufactures and markets products that save and sustain the lives of people living with hemophilia, immune disorders, infectious diseases, kidney disease, trauma, and other chronic and acute medical conditions. As a global, diversified healthcare company, Baxter applies a unique combination of expertise in medical devices, pharmaceuticals and biotechnology to create products that advance patient care worldwide.

¹The International Society of Nephrology and the International Federation of Kidney Foundations, World Kidney Day: Chronic Kidney Disease, http://www.worldkidneyday.org/pages/ckd.php.

²National Kidney Foundation, National Kidney Foundation: Chronic Kidney Disease, http://www.kidney.org/kidneyDisease/ckd/index.cfm.

³United States Renal Database System, “2008 Atlas,” http://www.usrds.org/atlas.htm.

⁴Heaf JG, et.al., “Initial survival advantage of peritoneal dialysis relative to haemodialysis,” Nephrology, Dialysis, and Transplantation, no. 17 (2002), 112-117.
Schaubel DE, et.al., “Comparing mortality rates on CAPD/CCPD and hemodialysis. The Canadian experience: fact or fiction?” Peritoneal Dialysis International, no. 18 (1998) 478-484.
Liem YS, et.al., “Comparison of hemodialysis and peritoneal dialysis survival in The Netherlands,” Kidney International, no. 71 (2007), 153-158.
Vonesh EF, et.al., “The differential impact of risk factors on mortality in hemodialysis and peritoneal dialysis,” Kidney International, no. 66 (2004), 2389-2401.

⁵Rubin HR, et.al., “Patient ratings of dialysis care with peritoneal dialysis vs hemodialysis,” Journal of the American Medical Association, no. 291 (2004), 697-703.
Juergensen E, et.al., “Hemodialysis and peritoneal dialysis: patients' assessment of their satisfaction with therapy and the impact of the therapy on their lives,” Clinical Journal of the American Society of Nephrology, no. 1 (2006), 1191-1196.
Kutner NG, et.al., “Health status and quality of life reported by incident patients after 1 year on haemodialysis or peritoneal dialysis,” Nephrology, Dialysis, and Transplantation, no. 20 (2005), 2159-2167.

⁶Paul M. Just, et.al., “Reimbursement and economic factors influencing dialysis modality choice around the world,” Nephrology, Dialysis, and Transplantation, January 30, 2008, no. 23, 2365-2373.

⁷David C. Mendelsshon, et.al., “ A prospective evaluation of renal replacement therapy modality eligibility,“ Nephrology, Dialysis, and Transplantation, August 28, 2008, 1-7.