Kidney disease risk higher in Hawai'i
By Alice Keesing
Advertiser Health Writer
Five hours a day, three times a week, Robert Littlejohn is hooked up to a dialysis machine — it keeps him alive by pumping out his blood, filtering it and returning it to his body.
Deborah Booker • The Honolulu Advertiser
Littlejohn has kidney failure, a result of the diabetes he was diagnosed with more than 20 years ago. It's part of his life now to pack up a book, some music and his Bambi blanket and head from his home in Mililani to the St. Francis Medical Center dialysis unit at Pearlridge so a machine can do what his kidneys no longer can.
Robert Littlejohn travels to Pearlridge three times a week for five hours of kidney dialysis treatment. The exhausting ritual has thoroughly altered his lifestyle.
"This is like a full-time job for me," Littlejohn said yesterday as the machine beside him whirred and his red blood swirled through loops of plastic tubes.
About 1,500 people in Hawai'i need dialysis to stay alive. That is expected to double in the next decade. And according to figures released today in a nationwide study by the National Kidney Foundation, another 200,000 people in Hawai'i are at risk for kidney disease or already have it and don't know it.
Screening can catch the onset of the disease, helping people live longer without the need for dialysis or transplants, according to the kidney foundation in a study published today in the American Journal of Kidney Diseases. The foundation is proposing new guidelines for doctors that would have more people be given the simple blood and urine tests that can catch the early stages of kidney disease.
"If it's caught early enough, it's like any other major illness: it can be delayed, it can be controlled," said Glen Hayashida, chief executive officer of the National Kidney Foundation of Hawai'i.
The kidneys filter waste from the bloodstream. When they are damaged, waste builds up in the body and patients will die without dialysis or a kidney transplant.
The study says 1 in 9 Americans age 20 or older are at increased risk or already has chronic kidney disease and doesn't know it.
People in Hawai'i are 30 percent more likely to have kidney failure than the national average.
Kidney failure hits those with high blood pressure, diabetes or a family history of kidney disease the hardest. Hawaiians, Filipinos, Japanese and the elderly also are at greater risk.
Dialysis has been a life saver for many, Hayashida said, but it's costly.
Three thousand people on dialysis would cost $130 million in Medicare, according to the kidney foundation. And then there's the cost to people's lives.
Littlejohn, 42, had to trade in his two full-time jobs when his kidneys failed in August 2000. He now works part-time for the Bishop Museum doing education and hula shows at the Hilton Hawaiian Village. But in the last month he has been too sick to get to work. The dialysis treatments alone are draining.
"Oh, man," Littlejohn said, searching for the words to describe a day of dialysis. "You feel like somebody kicked you in the chest. You're really tired and dizzy and sometimes short of breath."
Kidney disease often does not make itself felt until it is well advanced, said nephrologist Dr. Roland Ng, an associate professor at the University of Hawai'i medical school.
"You can do pretty well until you're down to about 10 percent (kidney function) then you might have some signs of fatigue, anemia, and you might start to lose your appetite, but that is pretty late, you've lost 90 percent of your kidney function," Ng said. "So the key, really, is early detection."
Diabetics and others in at-risk categories are routinely screened; Ng said that's not enough.
The kidney foundation is urging Hawai'i residents to take advantage of free kidney screenings held around the state or to ask their doctor for three routine tests: a blood test for creatinine, a urine test for protein and a measurement of blood pressure.
Because the guidelines are new, Hayashida said it's unlikely insurance companies will reimburse the cost of the tests to anyone except those considered at risk.
But if kidney disease is detected, it can be treated with lifestyle changes and drugs that can delay or prevent its progress.
Reach Alice Keesing at akeesing@honoluluadvertiser.com or 525-8014.
