For decades, Texas has struggled to control a silent killer among its residents: chronic kidney disease (CKD).
Gov. Greg Abbott recently appointed Dr. Francis Wright from San Antonio as chair of Texas’ Chronic Kidney Disease Task Force, a task force revitalized in 2019 and created in 2009 to address the state’s high CKD rates. The new assignment, Dr. Wright conceded, will be a challenge.
Here is the good news: new technology can dramatically increase early detection rates, helping curb this hidden pandemic – reducing health care costs and saving lives in the process. All it takes is a smartphone camera and an app.
The camera technology in smartphones has advanced so much in recent years that you can use it to perform a urine test at home to determine early warning signs of kidney disease. The test, known as an ACR test, measures the amount of a type of protein called albumin in your urine to determine the albumin-to-creatinine ratio.
This past summer, the Lone Star state tested this technology when it partnered with Healthy.io to send these smartphone-based ACR tests to qualifying Texans in San Antonio and the response was tremendous.
Sadly, as many as 80% of Americans at risk for the disease fail to take the typical ACR test, according to a recent study in Diabetes Care. Some struggle to schedule a test around their work or family care responsibilities.
For roughly 3.6 million people in the United States, a lack of access to reliable and affordable transportation limits their medical care options. Add to that the inability — or unwillingness — of many to visit medical providers during the pandemic and you have millions of people missing simple tests that could have a major impact on their quality of life.
Chronic kidney disease affects more than one in 7 U.S. adults, 15% of all adults in the nation, according to the estimates by the Centers for Disease Control. Even more disturbing is that as many as 9 in 10 of these individuals don’t know they have the condition because symptoms don’t surface until late stages, earning it the distinction of being called “the silent killer.”
Often, individuals are diagnosed in the emergency room when they have kidney failure and require dialysis or even a transplant. They sometimes point to years of vision problems, fatigue or leg swelling but by the time they are diagnosed, the kidneys are beyond repair.
Texas has been particularly hit hard. The state spends $4.8 billon a year on end-stage renal disease, the last stage of CKD. The state also ranks number 4 in the nation for having the highest rates of kidney disease, with South Texas being one of the areas hardest hit.
South Texas also has high rates of diabetes, hypertension and obesity, conditions that put individuals at higher risk for kidney disease. It is essential for these people to get simple blood and urine tests that determine how the kidneys are working.
The smartphone-based ACR test distributed in Texas is eliminating systemic barriers that prevent people from getting key diagnostic tests earlier and more efficiently. It has already been deployed nationally in Europe.
In the United Kingdom, the National Health Service has opted to shift ACR testing for patients at risk to the smartphone. The first stage of this national effort focuses on 600,000 people with diabetes and has already delivered improved outcomes. When given the option to test at home using a smartphone camera, test adherence increased from 0% to 50% among patients who had not done a urine test for kidney disease in the previous year. In the United States, health plans can more than double their current adherence rates.
Dr. Wright, who has been working on kidney disease for 40 years, understands the obstacles Texas faces to manage, prevent and detect CKD earlier. Texas and other states must look to technology to eliminate testing barriers if they want to truly tackle this silent killer.
Paula LeClair is the US GM of Healthy.io, the global leader providing platforms and services that transform the smartphone camera into a medical device.
