Sunday, August 4, 2013

IN THE NEWS: New NKF recommendations for screening

Based on some new findings in a recent AJKD study, the National Kidney Foundation now recommends annual screening with a simple urine albumin test that checks for protein in the urine, in specific high-risk groups. 
These include adults with:
  • Diabetes
  • High blood pressure
  • Age 60 years or older
  • Family history of kidney failure requiring dialysis or transplantation

Diabetes, HTN and family history of kidney disease makes sense and has always been part of the screening for kidney disease in past. Now, we are adding age >60 years or older based on the significantly high finding of >50% of americans likely to develop lifetime risk of CKD. The risk was higher in women. How do the authors come up with this risk? They used the current CKD prevalence rate of Americans with CKD and used the Markov chain model ( random process with memorylessness) to come up with statistics to detect the future risk. It is a model use to predict events in the future as a process moves in time. So in this case, current CKD prevalence using this model can predict what it could be based on risk factors and prediction of events what the CKD status would be years from now? The model is like the "drunkard walk" and how with each step, the position may change by +1 or −1 with equal probability. A use in medicine of this model can be found here and here

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