New kidney tool
can cut in half
isle dialysis cases

Health officials hope a new testing procedure will result in earlier detection of kidney disease and help reduce Hawaii's high rate of kidney failure.

They are focusing on a GFR (glomerular filtration rate) test based on the common blood test. It calculates how well the kidneys are filtering wastes from the blood.

Hawaii is the first state to have automatic GFR readings statewide, thanks to Diagnostic Laboratory Services and Clinical Laboratories, said Glen Hayashida, National Kidney Foundation of Hawaii chief executive officer.

The foundation notes that Hawaii's rate of kidney failure is about 30 percent higher than the national average, largely because of ethnic populations and a high rate of diabetes.

Hawaii patients on dialysis grew from 894 in 1992 to more than 2,000 last year, with medical costs estimated at more than $100 million a year, according to the foundation.

About half the cases can be prevented if caught early enough, the foundation said.

Hayashida and other foundation officials yesterday announced a campaign to inform medical professionals and the public about the GFR reading.

The blood test being used was "grossly insensitive" and people were close to kidney failure by the time they were identified, Hayashida said.

"Most people would say, 'One day I was really tired; I went to see my doctor, he ran tests and said my kidneys were failing.'

"Usually within 30 days they were on dialysis. Their whole life was turned upside down immediately. It's a common story, unfortunately," Hayashida added.

Hayashida said Kidney Foundation of Hawaii officials started meeting about two years ago with Diagnostic Labs. "We had many, many different approaches to the problem. Through a series of trial and error, we basically got to the point where GFR will automatically be calculated" once a blood test is ordered.

Raymond Yeung, computer programmer and vice president of Information Systems at Diagnostic Laboratory Services, "is the brains behind this," Hayashida said.

He said Yeung and Dr. Wes Kim, medical director of Diagnostic Labs, worked hard to develop the test as a standard reading in patient lab reports. Clinical Laboratories also "put in a lot of time recently to make sure we get it up so we're the first state to do this statewide," Hayashida said.

Diagnostic Labs launched the GFR test in February and Clinical Labs started it this month.

Cathy Bailey, a transplant nurse at St. Francis Medical Center-Liliha, said the automatic reading "will help a lot," allowing patients to correct problems to avoid end-stage kidney disease.

St. Francis does 60 to 80 kidney transplants annually but the waiting list has 400 patients, Bailey said.

Dr. Ramona Wong, a kidney specialist who was among doctors working with the Kidney Foundation the past couple of years to get GFR readings in lab reports, said, "It's great to see this come to fruition."

She said doctors have had to do calculations manually to estimate how much kidney function a patient had left.

The GFR will serve as "a better red light" for reduced kidney function, she said. "It serves as a good screening tool. It's overdue."