Chronic kidney disease from screening, detection, and awareness, to prevention.

Melody Sherwood,Peter A Mccullough

doi:10.1016/s2214-109x(16)30049-3

Abstract

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Chronic kidney disease from screening, detection, and awareness, to prevention.

Highlights

Figure: Screening and detection of chronic kidney disease (CKD) using estimated GFR and the spot urine ACR with the identification of cardiovascular risk before progression of CKD GFR=glomerular filtration rate
Even in high-income countries where routine laboratory tests are performed, CKD seems to lag considerably behind diabetes mellitus, hypertension, and cardiovascular disease in terms of patient and clinician awareness.[2]. This difference is partly due to the two-dimensional nature of CKD defined as a reduction in estimated glomerular filtration rate and the presence of markers of chronic kidney damage over 3 months time
To have the estimated glomerular filtration rate (eGFR) and albumin:creatinine ratio at the same time and clearly inform the patient of the potential presence of CKD is complex. With these challenges as the backdrop, Ene-Iordache and colleagues[3] report on 75 058 individuals screened for diabetes mellitus, hypertension, and CKD from low-income and middle-income countries (LMIC). They found 44% of people with hypertension and 31% of those with diabetes were unaware of these conditions, suggesting public health screening efforts such as those described by the authors have a very high yield when there may not be access to primary care and routine screening

Summary

Introduction

Figure: Screening and detection of CKD using estimated GFR (from measured serum creatinine) and the spot urine ACR with the identification of cardiovascular risk before progression of CKD GFR=glomerular filtration rate. Chronic kidney disease from screening, detection, and awareness, to prevention

Results

Conclusion