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April 17th, 2012 
FAKE NEWS for the Zionist agenda TUESDAY, April 17 (HealthDay News) — At least one in 10 U.S.
adults is estimated to have chronic kidney disease, but whether screening
and monitoring people in the earlier stages of the disease provides a
benefit just isn’t clear, a new review of the available clinical trials
revealed.
The finding doesn’t necessarily mean that early screening or monitoring
of kidney disease isn’t helpful, it just shows no clear evidence to prove
that it is. “We didn’t find direct evidence for benefits or harms. There
were no randomized controlled trials for screening or monitoring,” said
the study’s lead author, Dr. Howard Fink, a staff physician at the
Veterans Affairs Medical Center in Minneapolis, Minn.
But, when the reviewers looked at the treatment options available to
people with early-stage chronic kidney disease, they found evidence that
two types of blood pressure-lowering medication reduced progression to
end-stage kidney disease and one medication reduced the risk of death.
The two medication classes were angiotensin-converting enzyme (ACE)
inhibitors and angiotensin II-receptor blockers (ARBs). The benefits from
these medications were stronger in people who had worsening kidney disease
and those with diabetes, according to the review.
Results of the review are published in the April 17 issue of the
Annals of Internal Medicine.
Eleven percent of American adults have chronic kidney disease in its
earliest stages (one through three), according to the review. Chronic
kidney disease is more likely to occur in older people, and those with
other chronic medical conditions, such as heart disease, high blood
pressure and diabetes. Most people don’t have symptoms of early chronic
kidney disease. It is detected through urine and blood tests.
Not everyone with chronic kidney disease will develop end-stage renal
disease and need dialysis, but having early chronic kidney disease
increases a person’s risk of heart disease, stroke, kidney failure and
death, according to the review.
The researchers searched available medical literature from 1985 through
November 2011 for randomized, controlled clinical trials of people with
early chronic kidney disease. A randomized controlled trial, considered
the “gold standard” in research, is a study in which people are randomly
assigned to receive one of several interventions.
The investigators found no trials that evaluated screening or
monitoring for those with early disease, so they were unable to determine
whether early detection and follow-up care would be beneficial or not.
When they searched for early chronic kidney disease treatment trials,
they found 110 randomized controlled studies that included a number of
treatments.
The review found that ACE inhibitors decreased the risk of end-stage
renal disease by 35 percent and ARBs reduced the risk by 23 percent
compared to an inactive placebo. The risk reduction was most significant
for people who had signs of worsening kidney disease
(macroalbuminuria).
The researchers also found evidence that ACE inhibitors lowered the
risk of death by 21 percent compared to placebo in people who had more
serious kidney disease, cardiovascular disease and poorly controlled
diabetes.
“The risk of people with mild chronic kidney disease developing
end-stage renal disease is very low, so it may be that these medications
have a unique benefit in people with worse chronic kidney disease, or it
may be that you just don’t have enough statistical power in these trials
to see the benefits in people with milder chronic kidney disease,”
explained Fink.
ACE inhibitors include: captopril (Capoten), enalapril (Vasotec),
ramipril (Altace) and quinapril (Accupril). ARBs include: candesartan
(Atacand), valsartan (Diovan), losartan (Cozaar) and olmesartan (Benicar).
Other blood pressure-lowering medications didn’t provide the same
benefits as ACE inhibitors and ARBs. Statins (cholesterol-lowering drugs)
and beta blockers (drugs that help regulate heart rate and lower blood
pressure) showed a reduction in the risk of death and cardiovascular
events compared to placebo, but only in people with worsening kidney
disease, or high cholesterol or congestive heart failure.
“This review shows that the evidence in early chronic kidney disease is
very, very weak. The problem right now is that no one knows who will get
worse and progress to end-stage renal disease,” said Dr. Robert
Provenzano, chair of the department of nephrology at St. John Providence
Health System in Detroit, Mich.
Provenzano added that he wasn’t surprised the reviewers found ACE
inhibitors and ARBs to be most effective for people with early kidney
disease.
He said that if people are interested in keeping their kidneys healthy,
they should follow the same advice for keeping your heart healthy. Eat
right to control your blood sugar, cholesterol and blood pressure levels.
Limit the salt in your diet. Don’t smoke, and stay active.
More information
Learn more about chronic kidney disease from the National Kidney Foundation.
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