Abstract
Background:
Decisions on whether to screen for chronic kidney disease (CKD) or not remains contentious in nephrology. This study provides a global overview of early CKD identification efforts.
Methods:
Guidelines for scoping reviews were followed and studies were identified by searching Medline, Embase, Cochrane Library, CINAHL, ISI Web of Science and PsycINFO. Data extracted from included studies focussed on four themes: study population, measurement methods, interventions utilized, and available policies.
Results:
We identified 290 CKD screening and detection programs from 83 countries. Overall sample size was 3.72 million (North-East Asia – 1.19 million), detection of CKD was the aim in 97.6%, 63.1% used population-based screening methods, and only 12.4% were in rural populations. Reported CKD prevalence (stage 3-5) was higher in targeted (14.8%) than population-based studies (8.0%). Number of persons needed to screen to identify 1 case was also lower in targeted studies (7 versus 13). Single measurements (80%) and the combination of estimation of glomerular filtration rate with a urine test (albuminuria/proteinuria) (71.4%) were frequently used to detect CKD. Only 2.8% of studies included an intervention such as pharmacotherapy in identified cases. Policies on early identification were available in 30.1% of countries included.
Conclusion:
Methods for early CKD identification vary worldwide, often leading to wide variations in the reported prevalence. Efforts to standardize measurement methods for early detection, focus on high-risk populations, and ensuring that appropriate interventions are available to those identified with CKD will improve the value of programs and improve patient outcomes.
Decisions on whether to screen for chronic kidney disease (CKD) or not remains contentious in nephrology. This study provides a global overview of early CKD identification efforts.
Methods:
Guidelines for scoping reviews were followed and studies were identified by searching Medline, Embase, Cochrane Library, CINAHL, ISI Web of Science and PsycINFO. Data extracted from included studies focussed on four themes: study population, measurement methods, interventions utilized, and available policies.
Results:
We identified 290 CKD screening and detection programs from 83 countries. Overall sample size was 3.72 million (North-East Asia – 1.19 million), detection of CKD was the aim in 97.6%, 63.1% used population-based screening methods, and only 12.4% were in rural populations. Reported CKD prevalence (stage 3-5) was higher in targeted (14.8%) than population-based studies (8.0%). Number of persons needed to screen to identify 1 case was also lower in targeted studies (7 versus 13). Single measurements (80%) and the combination of estimation of glomerular filtration rate with a urine test (albuminuria/proteinuria) (71.4%) were frequently used to detect CKD. Only 2.8% of studies included an intervention such as pharmacotherapy in identified cases. Policies on early identification were available in 30.1% of countries included.
Conclusion:
Methods for early CKD identification vary worldwide, often leading to wide variations in the reported prevalence. Efforts to standardize measurement methods for early detection, focus on high-risk populations, and ensuring that appropriate interventions are available to those identified with CKD will improve the value of programs and improve patient outcomes.
| Original language | English |
|---|---|
| Pages (from-to) | 1341-1353 |
| Number of pages | 13 |
| Journal | Kidney international reports |
| Volume | 7 |
| Issue number | 6 |
| Early online date | 6 Apr 2022 |
| DOIs | |
| Publication status | Published - 1 Jun 2022 |
Bibliographical note
Funding Information:The authors thank Ms. Sophanny Tiv (University of Alberta) for creating the map used in Figure 1 . This is an ISN initiative supported by an unrestricted educational grant from AstraZeneca (no grant number).
Funding Information:
The authors thank Ms. Sophanny Tiv (University of Alberta) for creating the map used in Figure 1. This is an ISN initiative supported by an unrestricted educational grant from AstraZeneca (no grant number). VJ, AL, IGO, and FJC conceived the study design. The first version of the protocol was drafted by IGO and was revised by FJC, AG, EKT, JJN, EE, UEE, LNH, GA, JAD, AEF, RI, MMa, CM, MMo, RPF, VT, AL, and VJ. The search strategy was developed and performed by LNH. AG and EKT performed the screening, study selection, and collection of data from all included studies, and IGO adjudicated conflicts in study selection. All authors revised and critically reviewed this manuscript and approved the final version. Data extracted from the included studies in this review are available on request from the corresponding author.
Publisher Copyright:
© 2022 International Society of Nephrology
Keywords
- chronic kidney disease
- early detection
- estimated glomerular filtration rate
- intervention
- measurement
- screening