»People don’t notice anything«

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Ill kidneys suffer silently

Chronic kidney disease (CKD) is a widespread disease worldwide, and in this country with about ten million affected people. Only one third of those affected even know that their kidneys are becoming weaker. This is a major problem, says Professor Dr. Julia Weinmann-Menke, from the Department of Medicine at the University Medical Center Mainz, during the congress press conference of the German Society for Nephrology (DGfN) in Berlin. The kidneys play an essential role for the entire body – among others for the health of blood vessels, bones, and metabolism. Those who are unaware that their kidneys are diseased and therefore do not receive treatment – especially if they also have other conditions such as high blood pressure, diabetes, or obesity – face a much higher risk of hospitalization, since the kidneys negatively influence those other diseases, and unfortunately also a higher risk of death. In other words, chronic kidney weakness cannot be viewed in isolation. There is a close interaction: those with diseased kidneys are much more likely to develop heart and circulatory problems – which, in turn, have a negative effect on the kidneys.

Why do doctors so often fail to detect the disease? Until recently, there was no specific therapy for CKD, explained Weinmann-Menke. That means many general practitioners still assume that only accompanying conditions such as high blood pressure and diabetes can be treated to protect the kidneys indirectly. But now, there are specific therapies for CKD. »That’s why CKD needs to be recognized. You have to look for it,« emphasized the expert.

Even today, among people with diabetes, high blood pressure, or cardiovascular disease, only half are ever examined for kidney function – and even then, the concentration of the smallest protein in urine, albumin, is rarely measured. This crucial test is performed in fewer than one percent of at-risk patients. »That’s why the disease is recognized too rarely, and patients don’t receive the proper treatment. That’s fatal, because we now have therapies – even combinations – that can prevent dialysis,« said Weinmann-Menke.

To improve the situation quickly, anyone can ask their family doctor for a kidney function test. This is particularly advisable for people who are severely overweight, who have a family history of kidney disease, or who suffer from high blood pressure, diabetes and/or cardiovascular disease. Doctors should check creatinine and albumin levels. Because these tests are not yet fully covered by health insurance, patients may have to pay for them themselves – but the costs are low.

Weinmann-Menke also advocated for establishing kidney screening, which could be integrated into the »Check-up 35« (a routine preventive exam for adults in Germany). A key milestone toward earlier detection, she noted, was the World Health Organization (WHO)’s recognition of CKD as a global widespread disease in June this year. »That will promote preventive and public awareness programs,« she said. The DGfN is calling for a national kidney plan, ensuring sufficient research opportunities to evaluate new therapy options. Only then will CKD no longer be seen as a life-threatening disease but as a condition from which more and more people can be protected – preventing both dialysis and transplantation.

The second major group of dangerous kidney diseases, which often affect young people without their knowing it, are the glomerulonephritides (GN), explained Professor Dr. J. Menne, Chief Physician of the Clinic for Nephrology, Angiology, Hypertensiology, and Rheumatology at KRH Klinikum Siloah, Hannover. »The term glomerulonephritides comes from glomerulus, meaning kidney corpuscle, and nephritis, meaning inflammation in the kidney,« explained the DGfN Congress President. Unfortunately, GN also produces no symptoms. »People really don’t notice anything,« he said. While not long ago doctors didn’t know exactly what caused GN, today they can identify the origins of many forms in detail. The corresponding blood markers can be measured. This knowledge has significant benefits – it allows GN to be detected much earlier and treated successfully, sparing patients from dialysis.

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