People usually don't realize they have kidney disease until it's too late. High blood pressure or diabetes may go untreated for years, and by the time symptoms like nausea and fatigue show up -- and these are often misconstrued as the flu -- both kidneys are already damaged beyond repair.
Dr. Matthew Cooper, the director of kidney transplants at the University of Maryland, calls kidney disease a "time bomb".
"It's often silent in its early stages," he says. "Even in its end stages, there isn't a buzzer or a warning light that goes off and says your kidneys are the problem and you need to go figure it out."
Cooper says a true grassroots effort is the only way to stem what has become an ever-worsening epidemic. Texas, one of the most heavily affected states, has just begun to roll out the most comprehensive initiative in the nation.
As chair of the governor's task force on chronic kidney disease, Dr. A Osama Gaber, the transplant director at Methodist Hospital, is leading the rather aggressive charge. The Texas legislature recently approved a bill that will allow for state-level screening programs to determine the full extent of the problem, as well as who is most at risk.
If Gaber has his way, screening for at-risk populations will one day become a mandatory part of medical check-ups. This would allow doctors to find and treat kidney disease much earlier -- instead of taking 10 to 15 years to cause kidney failure, it would take 25 to 30. Once kidneys fail, the only option other than a transplant is dialysis -- which is incredibly painful and costly, as well as often debilitating.
Early detection and treatment might also save a lot of lives, according to Gaber.
"The task force has reached the conclusion that the ones who make it to dialysis are actually the lucky ones," Gaber says. "Maybe 50 percent of the people with chronic kidney disease will die before they even get to dialysis...as your kidney function decreases, your chances of dying from cardiovascular disease double, quadruples."
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Things like insurance and the poor economy will present formidable barriers. But more than that, Gaber is pushing a paradigm shift in the way we practice medicine.
"It's actually thinking about health in a public fashion rather than in the way we traditionally think about it, which is providing care for a patient. You're talking about providing systems of care for a very sophisticated problem," he says.
"But otherwise the doubling of kidney failure is going to double again in ten years. You're talking about almost a pyramidal thing that will never stop."
Click here for our cover story this week, the tale of a homeless man who thought he'd hit a $10,000 jackpot by selling his kidney.