Pilot study determining the feasibility of implementing the Disadvantaged Populations eGFR Epidemiology Study (DEGREE) protocol, point-of-care field measurements and a new module on risk factors for chronic kidney disease of unknown origin in Hispanic outdoor workers

Erika Figueroa-Solis,David Gimeno Ruiz De Porras,George L Delclos

doi:10.1186/s12882-021-02288-z

Abstract

BackgroundTo field test the Disadvantaged Populations eGFR Epidemiology (DEGREE) protocol, outdoor point-of-care (POC) testing for serum creatinine, and a new risk factor module on chronic kidney disease of undetermined origin (CKDu) in U.S. outdoor Hispanic workers.MethodsFifty workers were interviewed in Houston (TX). DEGREE and CKDu questionnaires were completed indoors. Anthropometrics and paired blood samples for POC and laboratory assay were completed outdoors over two periods (November–December 2017, April–May 2018).ResultsAdministration of DEGREE and CKDu questionnaires averaged 10 and 5 min, respectively, with all questions easily understood. We observed high correlations between POC and IDMS creatinine (r = 0.919) and BUN (r = 0.974). The POC device would disable testing when outdoor temperatures were above 85 °F or below 65 °F; this was adjustable.ConclusionsImplementation of DEGREE and the new CKDu module was straightforward and well understood. The POC device performed well in the field, with some adjustment in methods when temperature readings were out of range.

Highlights

To field test the Disadvantaged Populations Estimated Glomerular Filtration Rate (eGFR) Epidemiology (DEGREE) protocol, outdoor point-ofcare (POC) testing for serum creatinine, and a new risk factor module on chronic kidney disease of undetermined origin (CKDu) in U.S outdoor Hispanic workers
Regarding the comparison between POC and isotope dilution mass spectrometry (IDMS) measurements, we found that measurements of creatinine and blood urea nitrogen (BUN) correlated well across the range of temperatures, and had a slightly higher correlation coefficient during the hotter period (Table 3)
Results for BUN, creatinine and hemoglobin correlated well with those obtained from IDMS

Summary

Introduction

To field test the Disadvantaged Populations eGFR Epidemiology (DEGREE) protocol, outdoor point-ofcare (POC) testing for serum creatinine, and a new risk factor module on chronic kidney disease of undetermined origin (CKDu) in U.S outdoor Hispanic workers. CKD cases identified in high-income countries are typically associated with lifestyle-related risk factors, such as type II diabetes and hypertension [3]. Over the past 10–15 years, CKD cases have been described in low- and middle-income countries that do not fit this “usual” CKD pattern. These unusual cases predominantly affect male agricultural workers, often in their 30s and 40s, and are associated with high mortality [3,4,5]. Their prognosis is poor due to delays in diagnosis and limited availability of therapy (i.e., dialysis or renal transplantation)

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