衛生類：閱讀理解Kidney Disease
Hearts and kidneys： If one’s diseased， better keep a close eye on1 the other. Surprising new research shows kidney disease somehow speeds up heart disease well before it has ravaged the kidneys. And perhaps not so surprising， doctors have finally proven that heart disease can trigger kidney destruction， too.
The work， from two studies involving over 50，000 patients， promises to boost efforts to diagnose simmering kidney disease earlier. All it takes are urine and blood tests that cost less than $ 25， something proponents want to become as routine as cholesterol checks. 2 “The average patient knows their cholesterol，”says Dr. Peter McCullough， preventive medicine chief at Michigan’s William Beaumont Hospital. “The average patient has no idea of3 their kidney function.”
Chronic kidney disease， or CKD， is a quiet epidemic： Many of the 19 million Americans estimated to have it don’t know they do. The kidneys lose their ability to filter waste out of the bloodstream so slowly that symptoms arent obvious until the organs are very damaged. End-stage kidney failure is rising fast， with 400，000 people requiring dialysis or a transplant to survive， a toll that has doubled in each of the last two decades， s
And while CKD patients often are terrified of having to go on dialysis， the hard truth is that most will die of heart disease before their kidneys disintegrate to that point， something kidney specialists have recognized for several years but isnt widely known， s Indeed， the new research is highlighted in this months Archives of Internal Medicine with a call for doctors who care for heart patients to start rigorously checking out the kidneys， and for better care of early kidney disease. 7
The link sounds logical. After alla ， high blood pressure and diabetes are chief risk factors for both chronic kidney disease and heart attacks. But the link goes beyond" those risk factors， stresses McCullough： Once the kidneys begin to fail， something in turn10 accelerates heart disease， not just in the obviously sick or very old， but at what he calls “a shockingly early age.” McCullough and colleagues tracked more than 37，000 relatively young people―average age 53 ― who volunteered for a kidney screening. Three markers of kidney function were checked： The rate at which kidneys filter blood， called the GFR or glomerular filtration rate11； levels of the protein albumin in the urinei and if they were anemic. They also were asked about previously diagnosed heart disease.
The odds of having heart disease rose steadily as each of the kidney markers worsened. More striking was the death data. At this age， few deaths are expected， and indeed just 191 people died during the study period. But those who had both CKD and known heart disease had a threefold increased risk of death in a mere 2 1/2 years， mostly from heart problems. “This study is very much a wake-up call，” McCullough says.
練習：
1. How can one learn earlier whether he or she suffer simmering kidney disease?
A By cholesterol checks.
B By urine and blood tests.
C By keeping a close eye on ones kidneys.
D By measuring the volume of urine output.
2. How many Americans suffer chronic kidney disease according to an estimation?
A 1，9，000，000.
B 400，000.
C 50，000.
D 37，000.
3. How many Americans suffered end-stage kidney failure and required dialysis or a transplant to survive twenty years ago according to an estimation?
A 400，000.
B 300，000.
C 200，000.
D 100，000.
4. What did the Archives of Internal Medicine call for doctors caring for heart patients to do?
A To examine their patients heart function carefully.
B To have their patients chests X-ra Yed regularly.
C To select volunteers from their patients for a kidney screening.
D To start rigorously checking out their patients kidneys.
5. Which of the following is NOT one of the three markers of kidney function?
A Levels of the protein albumin in the urine.
B Levels of the white blood cells in the blood.
C The rate at which kidneys filter blood.
D Whether one is anemic or not
答案與題解：
1.B 第二段第一、二句說到，加速慢性腎病的診斷所使用的方法就是尿檢和血檢，故B項為正確答案。
2.A 第三段第一句說。在估計患有慢性腎病的1，900萬美國人呼叫很多人不知道自己患此病，可見A項是正確答案。
3.D 第三段最后一句說.終末期腎衰竭病人數日迅速增加，有40萬人需要腎透析或腎移植才能存活.這個數字在近20年小每10年翻一番。按此計算，10年前應為20萬人，20年前就應是10萬人，故正確答案應為1)。
4.D 第四段最后一句說到，《內科檔案》雜志號召為心臟病人治病的醫生要開始嚴格地檢查病人的腎臟，D項正是它要求做的事情。
5.B 第五段倒數第二句列㈩了腎功能的三個標志物.選項C、A、D均包括在內，唯獨沒有B項，故B項是本題答案。