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Cost of treating diabetes, kidney failure rising; multi-benefit drug offers hope | Philstar.com
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Health And Family

Cost of treating diabetes, kidney failure rising; multi-benefit drug offers hope

- Chat Alejandro -
The cost of treating diabetes, hypertension and kidney failure is rising steadily and is affecting productivity, prompting health experts to call for more preventive measures.

They said Type-2 diabetes is reaching epidemic proportions and the loss of kidney function associated with diabetes has become the single most common cause of end-stage renal disease (ESRD), or death of the kidney, in many countries, including the United States and the Philippines.

The experts said this has resulted in the increasing cost of treating diabetes and loss in productivity. In the US alone, costs related to the treatment of the disease, including productivity loss, total about $98 billion annually.

Four years ago, almost 400,000 people in the US suffered from ESRD with resulting healthcare costs amounting to almost $17 billion. The cost is expected to surpass $28 billion by 2010.
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Of the types of diabetes, Type-2 diabetes, also called adult-onset diabetes or non-insulin dependent diabetes mellitus (NIDDM), is more common and occurs when the body is unable to produce enough insulin. Type-2 affects people 40 years old or older, and although their bodies produce insulin normally, the cells no longer respond adequately to this vital hormone. This group accounts for 80 percent of diabetics. And diabetics have very high risk of developing cardiovascular disease.

According to the World Health Organization, of the 146 million patients worldwide with Type-2 diabetes, approximately 60 million have high blood pressure or hypertension, which is two to three times more common in these patients than in non-diabetics.

Hypertension occurs when the blood exerts too much force on the artery walls. It makes the heart and blood vessel system work harder and can eventually damage the blood vessels throughout the body, or even the heart itself.

Individually, diabetes and high blood pressure increase the risk of kidney disease. However, the risks of having a kidney disease rise dramatically when the person has diabetes and high blood pressure.

Healthy kidneys are essential for a healthy body. Kidneys maintain salt and water imbalance and help filter our harmful wastes from the blood to form urine. Sometimes kidneys can be damaged or diseased, preventing them from functioning properly.

Diabetes and hypertension are the two most common causes of kidney disease or damage. As kidney disease progresses, it may lead to permanent kidney failure or ESRD, a serious condition in which the patient requires dialysis or kidney transplantation in order to live.

Dialysis is a procedure that cleans and filters the blood, removes harmful wastes, extra salts and fluids from the body. Kidney transplantation is a surgical procedure in which a healthy kidney is removed from one individual and implanted into another individual. Both procedures are costly and may disrupt the patient’s normal productive life. What ‘s worse is that prognosis for patients with ERSD is bleak. About 30 percent of those undergoing dialysis and 15 percent of those receiving their first kidney transplant die within two years.
Good news
Results from a new clinical trial called RENAAL (Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan) show that treatment with blood pressure lowering drug losartan can protect the kidney and dramatically delay the progression of ESRD.

RENAAL, which appeared recently in the New England Journal of Medicine, was conducted among patients with Type-2 diabetes and kidney disease. Investigators reported that losartan significantly reduced the risk of progression to ESRD requiring dialysis or kidney transplantation by 28 percent.

RENAAL is the first and only study to report that a drug reduces ESRD in this patient population. Moreover, losartan provided a cardio-protective benefit in the study by reducing the risk of hospitalization for heart failure.

New analysis from RENAAL also show that treatment with losartan saves cost. According to a recent study, the United States health care system alone could save more than $4billion over four years by treating patients with Type-2 diabetes and kidney disease with losartan.

ANTAGONIST LOSARTAN

BLOOD

DIABETES

DISEASE

KIDNEY

NEW ENGLAND JOURNAL OF MEDICINE

REDUCTION OF ENDPOINTS

UNITED STATES

UNITED STATES AND THE PHILIPPINES

WORLD HEALTH ORGANIZATION

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