Abstract: SA-PO1073
Screening Programs for Early Detection of CKD: A Systematic Literature Review
Session Information
- CKD: Epidemiology, Risk Factors, and Prevention - 3
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Kushner, Pamela R., University of California Irvine, Irvine, California, United States
- Mende, Christian W., University of California San Diego, La Jolla, California, United States
Background
Early detection of chronic kidney disease (CKD) allows intervention to delay progression and other adverse outcomes. Kidney Disease: Improving Global Outcomes (KDIGO) guidelines advise screening high-risk groups with albumin-to-creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR); diagnostic if abnormality in one/both for ≥ 3 months. We investigated CKD screening programs in the US, Canada, Australia, and UK.
Methods
Systematic literature review (SLR) of CKD screening programs in patients with diabetes and/or hypertension between Jan 2018 – Oct 2023.
Results
Of 2361 records screened, 52 full-text reports were assessed, and 23 publications (of 21 studies) included. In addition to diabetes and/or hypertension (13 studies), high-risk groups included indigenous populations (4 studies), underserved areas (3 studies) and older population (1 study). Of the 21 studies, 5 reported screening prevalence and 16 described screening programs. Also, 7 studies reported 1 test (ACR or eGFR), 9 used ACR + eGFR, 5 used ACR + serum creatinine. Of the 16 screening programs, 9 were in community care and 7 in primary care. Prevalence (mean weighted) of screening in high-risk patients was 4-fold greater in community vs. primary care. Low screening rates were reported for patients with hypertension and diabetes (Fig. 1). Of 10 studies reporting assessment frequency, only 3 repeated ACR within 1 year.
Conclusion
This SLR suggests a low prevalence of CKD screening of high-risk patients, particularly in primary care. Contrary to KDIGO guidelines, approximately one-third of studies performed incomplete screening (only 1 test); follow-up testing was infrequent or not reported. Inadequate testing for CKD and lack of adherence to KDIGO guidelines are delaying CKD diagnosis and appropriate early therapy.
Funding
- Commercial Support – Boehringer Ingelheim Pharmaceuticals, Inc. (BIPI) & Lilly, USA LLC