Chronic Kidney Disease in North Carolina

Abstract

N C Med J May/June 2008, Volume 69, Number 3 n the middle of the last century, chronic diseases overtook communicable diseases as the leading causes of death in the United States. Public health campaigns and the scientific community have responded and developed national strategies to prevent and cure diseases including cancer, diabetes, HIV/AIDS, and hypertension. While the morbidity and mortality resulting from these diseases warrant this attention, other equally serious chronic diseases unfortunately receive less attention. One of these conditions is chronic kidney disease (CKD). Death from kidney failure, the most severe form of CKD, is more common than many of the most prevalent forms of cancer. (See Figure 1.) Chronic kidney disease encompasses various levels of kidney damage ranging from a relatively asymptomatic decline in kidney function to kidney failure. Chronic kidney disease, in all its stages, is estimated to affect 13% of the United States population. In North Carolina alone, almost 1 million people have CKD not including those with kidney failure. Despite the large number of people living with CKD, there is an overall lack of knowledge about the disease even among people who have it. Nationally, only about 25% of Americans diagnosed with CKD reported awareness of weak or failing kidneys. Among the general population, there is even less awareness. Preliminary data from a University of North Carolina at Chapel Hill (UNC) Kidney Center study shows that many people are unfamiliar with the risk factors for CKD. The combination of high disease burden and low public awareness warranted an in-depth study of how North Carolina can best act to lower the CKD disease burden in the future. In 2006 the North Carolina General Assembly asked the North Carolina Institute of Medicine to convene a task force to study chronic kidney disease (Session Law 2006-248). The task force was funded by the state of North Carolina through its annual appropriation to the North Carolina Institute of Medicine. Marcus Plescia, MD, MPH, chief of the Chronic