Awareness of kidney disease in the US population: findings from the National Health and Nutrition Examination Survey (NHANES) 1999 to 2000.

BACKGROUND: The prevalence of end-stage renal disease (ESRD) in the US population has been predicted to increase by 48% during the next decade and will pose a significant health cost burden. Early identification and treatment of chronic kidney disease (CKD) is necessary to delay progression from CKD to ESRD. CKD awareness among patients is crucial to early intervention programs, but its prevalence and characteristics in the noninstitutionalized US population are unknown. METHODS: The National Health and Nutrition Examination Survey 1999 to 2000 was used to determine prevalence estimates of kidney disease awareness, as well as demographics, health care access, and comorbid characteristics, of participants with CKD. RESULTS: In participants with CKD, 40.5% of patients with stage 1, 29.3% of patients with stage 2, 22.0% of patients with stage 3, and 44.5% of patients with stage 4 CKD were aware of their kidney disease, respectively. The aware and unaware groups did not differ by health care access. In multivariate regression modeling, lack of awareness was significantly associated with sex, race-ethnicity distribution, and hypertension. CONCLUSION: Kidney disease awareness is low among a representative sample of the noninstitutionalized US population. Groups at greater risk for kidney disease, such as non-Hispanic blacks, patients with hypertension, and men, were more likely to be unaware of having kidney disease, even with health care access similar to that of the aware group. Increased efforts to promote kidney disease awareness are needed and probably should target primary care providers involved in the screening process.

The budding yeast, Saccharomyces cerevisiae, as a model for aging research: a critical review.

In this review we discuss the yeast as a paradigm for the study of aging. The budding yeast Saccharomyces cerevisiae, which can proliferate in both haploid and diploid states, has been used extensively in aging research. The budding yeast divides asymmetrically to form a 'mother' cell and a bud. Two major approaches, 'budding life span' and 'stationary phase' have been used to determine 'senescence' and 'life span' in yeast. Discrepancies observed in metabolic behavior and longevity between cells studied by these two systems raise questions of how 'life span' in yeast is defined and measured. Added to this variability in experimental approach and results is the variety of yeast strains with different genetic make up used as 'wild type' and experimental organisms. Another problematic genetic point in the published studies on yeast is the use of both diploid and haploid strains. We discuss the inherent, advantageous attributes that make the yeast an attractive choice for modern biological research as well as certain pitfalls in the choice of this model for the study of aging. The significance of the purported roles of the Sir2 gene, histone deacetylases, gene silencing, rDNA circles and stress genes in determination of yeast 'life span' and aging is evaluated. The relationship between cultivation conditions and longevity are assessed. Discrepancies between the yeast and mammalian systems with regard to aging are pointed out. We discuss unresolved problems concerning the suitability of the budding yeast for the study of basic aging phenomena.

Paradigms in aging research: a critical review and assessment.

This is the first in a series of articles in which we intend to critically review some of the currently used models in gerontology research and evaluate their contribution to advancing our understanding of the phenomenon of senescence. The major theories of aging are considered. We discuss what makes a model useful in general and for aging research in particular. We suggest criteria for the selection of paradigms for the study of aging. The criteria we suggest for identifying underlying mechanisms that lead to age related changes are: intraspecies universality, intrinsicality, progressiveness, and interspecies universality. The subsequent articles of this series shall consider the merits and possible drawbacks of some of the most commonly used models of the biology of aging: (a) the yeast Saccharomyces cerevisiae; (b) the nematode, Caenorhabditis elegans and the fruitfly, Drosophila melanogaster; (c) mammalian cells in culture and telomerase model; (d) mitochondria and aging; (e) progeroid syndromes; (f) in vivo studies with laboratory rodent strains; and (g) plant senescence.