Advances in CKD Detection and Determination of Prognosis: Executive Summary of the National Kidney Foundation–Kidney Early Evaluation Program (KEEP) 2012 Annual Data Report

Abstract

During 2012, the National Kidney Foundation (NKF)–Kidney Early Evaluation Program (KEEP) continued its efforts toward early detection of chronic kidney disease (CKD) in populations at high risk for kidney disease and in improving awareness of CKD across the globe. Through the completely volunteer participation of the nephrology community, including physicians and our allied health care partners, KEEP continues to screen volunteer participants as part of a national effort to detect and track CKD. In 2012, we observed some changes in the CKD landscape, including questions regarding the utility of CKD screening and detection strategies from the US Preventive Services Task Force.1 Through the years, data derived from KEEP have provided important observations regarding detection and risk-stratification strategies using estimated glomerular filtration rate (eGFR) and proteinuria.2–4 In this past year, KEEP provided new information on topics including blood pressure control, disorders of mineral metabolism, and awareness of CKD and access to health care as related to CKD outcomes.5–11 In this supplement to AJKD, we focus on the variable nature of CKD progression. Interest is increasing in exploring factors that influence disease progression beyond traditional measures such as blood pressure and glycemic control, and in determining the contribution of socioeconomic factors.12;13 We present three articles highlighting factors that influence disease progression in KEEP participants: 1) Chang et al describe risk factors for progression to end-stage renal disease (ESRD) among KEEP participants with preserved eGFR at screening, with and without albuminuria14; 2) Amin et al report on whether or not synergism in using eGFR and albuminuria enhances risk prediction for death and disease progression15; and 3) Jurkovitz et al report on insurance status as a risk factor for disease progression.16