NEW YORK (Reuters Health) - Between 1990 and 2001, the number of people with chronic kidney failure in the US rose from 697 to 1424 cases per million population, according to a report released Thursday.

Better control of diabetes and high blood pressure, key risk factors for renal failure, could help bring this figure back down, the authors note.

"We knew there was going to be an increase in chronic kidney failure, but we were surprised at the magnitude," Dr. Wayne Giles, Associate Director for Science at the Centers for Disease Control and Prevention, told Reuters Health.

"Hypertension and diabetes account for 60 percent of the cases of chronic kidney failure and we knew that the prevalence of both of those conditions was increasing," Giles said. However, "we were somewhat surprised that there was actually a 54 percent increase in cases not caused by hypertension and diabetes," he added.

Giles believes that this increase could be due to the aging of the population as well as changes in the racial/ethnic make-up of the population.

The new findings, which appear in the CDC's Morbidity and Mortality Weekly Report, are based on an analysis of data from the United States Renal Data System.

All 50 states experienced a rise in prevalence during the 11-year study period. The most dramatic change, an increase of 204 percent, occurred in Alaska, whereas the smallest change, a rise of 78 percent, occurred in New Hampshire.

Despite the changes that occurred, the states with the highest and lowest number of cases per million population remained the same. The District of Columbia had the highest number of cases (3709 per million in 2001), whereas Alaska had the lowest number (811 per million in 2001).

"Racial, ethnic, age, and economic factors probably all play a part in explaining why some regions, such as Washington, DC, have higher rates of chronic kidney failure than others," Giles said.

As for why Alaska experienced such a marked increase in cases, he notes that the state had very low rates in 1990 and that it may just be "catching up" to other states now. "It also could relate to improved detection and reporting of cases."

To reduce the prevalence of chronic kidney failure, the CDC recommends that healthcare providers improve their efforts to control diabetes and high blood pressure. In addition, kidney function should be monitored in patients at high risk for kidney disease, the agency states.

SOURCE: Morbidity and Mortality Weekly Report, October 8, 2004.

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