Sometimes VA emails contain information and news about their research that is valuable for us to read. For example, 34.3-47.3% of veterans in VISN 2 network have chronic kidney disease (CKD). The ROs are located in Buffalo and New York City and Buffalo was very involved in this targeted regional research. The BVA also seems unaware of these remarkable and terrible statistics based on the decisions I’ve read.
Study population: VISN 2 individuals seen. Number: 75,787 Scope: One year in 2007.
Prevalence of various comorbidities among veterans with chronic kidney disease and its comparison with other datasets (link to study in Journal Renal Failure Volume 38, 2016 – Issue 2–published online Dec. 15, 2015.)
“The prevalence of CKD varied depending on the number of eGFR values used. Based on the MDRD equation using two values of eGFR, the prevalence of CKD was 34.3%, while it was 47.3% by MDRD equation using one eGFR value. The prevalence of CKD in the veteran population is much higher than estimated in US population from the NHANES and KEEP datasets.”
Definition of CKD calls for two consecutive measurements of eGFR < 60 mL/min per 1.73m2 that are at least three months apart… we have also calculated prevalence of CKD as the ratio of patients with at least two outpatient eGFRs less than 60 mL/min/1.73m2, at least 90 days apart, prior to the end of March 2008 (the numerator) to the total number of the study population (MDRD-2).
Ten years on–How are the RO’s applying this information, if at all, for VISN 2 vets? With up to 47.3% of veterans diagnosed by the VA with chronic kidney disease, are they getting justice or are they likely to live long enough to get justice?
Let’s look at four kidney cancer BVA decisions based on claims originally rejected by VISN 2 ROs.
RO NYC: Citation Nr: 1815713 ( 03/16/18) Kidney cancer; DAV did not do their homework; RO lost his records; Vet suspects asbestos exposure; Had two IMOs. Benefit-of-the-doubt? Denied by Lesley A. Rein, VLJ
Buffalo RO: Citation Nr: 1734058 (08/18/17) VVA–renal (kidney) and prostate cancer +
Remanded by Michael Martin, VLJ.
RO NYC/RO Kentucky Citation Nr: 1806565 (02/01/18)
Atty, Stephen J. Wenger, Camp Lejeune CUE WIN with
Matthew W. Blackwelder, VLJ
Buffalo RO–Citation Nr: 1749918 (11/02/17).
kidney cancer, secondary to prostate; VVA
” Veteran may establish service connection based on exposure to herbicide agents with proof of actual direct causation.” Second remand
Nathan Kroes, VLJ
Somehow I doubt that this old study is going to be updated any time soon–it’s too damning. With statistics like this, CKD should be presumptive in VISN 2 and would be if similar studies have been done elsewhere. There may be unpublished and published studies out there. How likely are non-VA kidney doctors to know about research?
This year we learned that my old Marine has stage three kidney disease and therefore his diet has had to change. We are in VISN 1. Plattsburgh NY is about 26 miles from our place by road, causeway and ferry. My guess is that VISN 1 also has high CKD numbers because it takes many weeks to get an appointment with a private specialist.
Thank you to VA Dr. Anna Jovanovich for your interview and for your work in Denver, Colorado. We need more people like you to help veterans. If you’re shocked at the data, so should we be. This study provides backup for the VISN 2 veterans who suspect that their CKD is service-connected. They are probably right based on the 2007 statistics in comparison with the civilian population in their region for the same period as shown in the study tables. If anyone thinks I’m reading this all wrong, do comment because I have zero training in any field related to medical science.