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Brussels, 15 November 2004

–  The International Society of Nephrology (ISN) today asked national health bodies around the world to consider the urgent implementation of proactive albuminuria screening.  Such action ?allowing for the early detection of renal damage, followed by treatment to prevent further deterioration of the renal function?- will reduce the number of patients suffering from kidney failure, heart failure and diabetes (in both the short and long term) and their associated costs.These recommendations were presented at press conference held in the Hague in the presence of  Prof. Kingma, Inspector General of Health and Chief Medical Officer of The Netherlands,

The costs of kidney failure, heart failure and diabetes account for the majority of health care budgets today. Worldwide more than 60 million individuals are estimated to have some degree of chronic kidney disease.  Many of them will either die from cardiovascular events or will develop kidney failure, requiring renal replacement therapy (dialysis or kidney transplantation). More than 1.5 million people across the globe are currently alive through either dialysis or kidney transplantation. This figure is expected to double in the next 10 years and the total cumulative global cost for this treatment to exceed ? 1 trillion. 

?Given these daunting statistics, we believe that early detection of renal impairment, followed by preventive treatment, is now a global health priority,? stated Prof. Jan J. Weening, President of the International Society of Nephrology and Head of the Department of Pathology at the Academic Medical Center, University of Amsterdam, The Netherlands.  ?We now know that simple testing for albuminuria is extremely efficient as an early indicator of renal malfunction. It is essential that high-risk patients are systematically screened in the immediate and advisable to extend this to the public at large as a second step.?

Research carried out by eminent members of the ISN from across the globe, the most recent of which was discussed by European and American nephrologists in Amsterdam this weekend at ISN?s symposium on the global need for prevention of kidney failure, is the foundation for the ISN?s recommendations. ?Patients with albuminuria  are not only at risk for kidney failure but also for heart failure and for the development of diabetes? explained ISN member, Prof. Dick de Zeeuw, Head of the Department of Clinical Pharmacology at the University Medical Centre, Groningen, The Netherlands. ?Until very recently, albuminuria was associated with a specific renal abnormality, it is now recognized to reflect generalized vascular endothelial damage. That damage is easily detected by collecting urine in which the albumin can be measured.?

Recent studies from Groningen, the Netherlands and other European countries show that drugs which lower albuminuria improve renal and cardiac prognosis and reduce the risk of developing diabetes. These treatments are not only cost effective but cost saving.

The ISN is therefore advocating systematic screening with a simple and cheap test for measuring albumin in the urine. This simple test provides sufficient early evidence of risk for kidney failure, heart failure and diabetes prompting preventive action. The ISN recommends that current renoprotective treatments (in patients with advanced renal failure) should now be extended to those with early stages of renal failure (stage 1 and 2), especially those with albuminuria.

?I welcome these recommendations and will inform my CMO colleagues during the EU CMO meeting this week. The reduction and treatment of chronic degenerative diseases are key priorities for public health systems today.  Screening that will allow for early identification of renal impairment and cardiovascular risk is vital but should  be considered as part of an integrated approach towards correct diagnosis and suitable treatment for these interrelated diseases,? commented Prof. Kingma as he received the recommendations from ISN President Jan. J. Weening.  The ISN?s formal recommendations Prevention of Progressive Renal and Cardiovascular Failure: A Call to Action will be presented to the Chief Medical Officers (CMOs) of the European Union Member States by Prof. Kingma as he chairs their meeting in the Hague on Wednesday 17 November.

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