Screening For Kidney Disease Research Articles

Screening for chronic kidney disease in Egyptian type 2 diabetic patients

Background Screening is an important strategy to address the burden of chronic kidney disease (CKD) in diabetic population. International clinical guidelines recommend CKD screening for individuals with risk factors such as diabetes using laboratory assessments of glomerular filtration rate (GFR) and urine albumin excretion. To assess the implementation and outcomes of screening programs for CKD in type 2 diabetic patients. Patients and methods A cross-sectional study was conducted that included 200 adult type 2 diabetic patients in Alagouza Hospital. Patients on hemodialysis and those with type 1 diabetes mellitus were excluded. Patients were screened for CKD using urinary albumin/creatinine ratio and average estimated glomerular filtration rate. Patients with CKD were further investigated for extrarenal diabetic complications such as peripheral vascular disease and cardiovascular complications. Results Overall, 55% of the studied patients were males, with a mean age of 60.09±8.55 years. Among diabetic complications, nephropathy was the most common (53%), followed by history of neuropathy (44.5%), and retinopathy evidenced in fundus examination (34.516%). History of stroke presented in 17.5% of patients. Peripheral neuropathy, retinopathy, and stroke history were more common in nephropathic patients compared with patients without nephropathy (62/27, 61/8, and 22/13, respectively). Patients with evidenced nephropathy who were further investigated for extrarenal diabetic complications showed peripheral vascular disease in 32.1% (34 patients), with three patients undergoing amputation. Heart failure and ischemic changes were seen in 17.9% (19 patients). Conclusion Screening of diabetic nephropathy in patients with type 2 diabetes mellitus helps in early treatment and avoids its more serious complications such as progression to end-stage renal disease and other extrarenal diabetic complications.

Prevalence of chronic kidney disease and associated factors among patients visiting renal unit of St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia: A cross-sectional study design.

Objective:This study aimed to assess the magnitude of chronic kidney disease among patients attending the renal unit of St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia.Methods:Institution-based cross-sectional study was conducted among 620 randomly selected patients who visited St. Paul’s Hospital Millennium Medical College renal unit from 1 January to 31 December, 2019. Data on sociodemographic characteristics, clinical conditions, behavioral risk factors, electrolytes, and renal function tests were extracted from patients’ medical records. To enter and analyze data, EpiData 3.1 and SPSS 22 were used, respectively. Bivariable and multivariable logistic regression analyses were conducted to see the association between predictor variables and chronic kidney disease. Adjusted odds ratio at 95% confidence interval was used to describe significant association. A p-value <0.05 was considered to declare an association between chronic kidney disease and independent variables.Results:Of 620 patients, 139 (22.4%; 95% confidence interval: 19.2, 25.6) and 61 (9.8%; 95% confidence interval: 7.4, 12.3) had chronic kidney disease using cut-off value of 90 and 60 ml/min/1.73 m2, respectively. Having urinary tract obstruction (adjusted odds ratio = 2.32; 95% confidence interval: 1.32, 4.06), hypertension (adjusted odds ratio = 4.06; 95% confidence interval: 2.50, 6.59), diabetes mellitus (adjusted odds ratio = 2.80; 95% confidence interval: 1.62, 4.85), cardiovascular disease (adjusted odds ratio = 2.54; 95% confidence interval: 1.60, 4.01), and age (adjusted odds ratio = 1.83; 95% confidence interval: 1.44, 3.57), family history of chronic kidney disease (adjusted odds ratio = 2.26; 95% confidence interval: 1.36, 3.75) were factors positively associated with having chronic kidney disease.Conclusion:Nearly, one out of five and one out of ten patients who visited the renal unit had chronic kidney disease using the two thresholds as a cut value. Patients with concomitant urinary tract obstruction, age, hypertension, diabetes mellitus, cardiovascular disease, and a family history of chronic kidney disease were more likely to develop chronic kidney disease. Regular screening for chronic kidney disease, optimal blood sugar, and blood pressure management should be practiced.

Multiple Stakeholder Perspectives on the Reinvigorated Case for Kidney Disease Screening.

The United States Preventive Services Task Force has no current recommendation to guide primary care physician screening for chronic kidney disease (CKD). This is misaligned with the scope of the CKD public health emergency, recommendations from clinical practice guidelines, health spending on CKD, the changing landscape of CKD detection and treatment, and the focus by policymakers on identifying tangible approaches to improving health equity. This review summarizes patient, clinician, health equity, and health system perspectives in support of screening adults with risk factors for CKD. This review concludes with the assessment that the United States Preventive Services Task Force should revisit targeted CKD screening specifically for adults with diabetes and/or hypertension.

Comparison of Machine Learning With Logistic Regression for Prediction of Chronic Kidney Disease in the Thai Adult Population

Background: Chronic kidney disease (CKD) takes huge amounts of resources for treatments. Early detection of patients by risk prediction model should be useful in identifying risk patients and providing early treatments.&#x0D; Objective: To compare the performance of traditional logistic regression with machine learning (ML) in predicting the risk of CKD in Thai population.&#x0D; Methods: This study used Thai Screening and Early Evaluation of Kidney Disease (SEEK) data. Seventeen features were firstly considered in constructing prediction models using logistic regression and 4 MLs (Random Forest, Naïve Bayes, Decision Tree, and Neural Network). Data were split into train and test data with a ratio of 70:30. Performances of the model were assessed by estimating recall, C statistics, accuracy, F1, and precision.&#x0D; Results: Seven out of 17 features were included in the prediction models. A logistic regression model could well discriminate CKD from non-CKD patients with the C statistics of 0.79 and 0.78 in the train and test data. The Neural Network performed best among ML followed by a Random Forest, Naïve Bayes, and a Decision Tree with the corresponding C statistics of 0.82, 0.80, 0.78, and 0.77 in training data set. Performance of these corresponding models in testing data decreased about 5%, 3%, 1%, and 2% relative to the logistic model by 2%.&#x0D; Conclusions: Risk prediction model of CKD constructed by the logit equation may yield better discrimination and lower tendency to get overfitting relative to ML models including the Neural Network and Random Forest.&#x0D;

Diagnostic Yield of Population-Based Screening for Chronic Kidney Disease in Low-Income, Middle-Income, and High-Income Countries

Population-based screening for chronic kidney disease (CKD) is sometimes recommended based on the assumption that detecting CKD is associated with beneficial changes in treatment. However, the treatment of CKD is often similar to the treatment of hypertension or diabetes, which commonly coexist with CKD. To determine the frequency with which population-based screening for CKD is associated with a change in recommended treatment compared with a strategy of measuring blood pressure and assessing glycemia. This cohort study was conducted using data obtained from studies that evaluated CKD in population-based samples from China (2007-2010), India (2010-2014), Mexico (2007-2008), Senegal (2012), and the United States (2009-2014), including a total of 126 242 adults screened for CKD. Data were analyzed from January 2020 to March 2021. The primary definition of CKD was estimated glomerular filtration rate less than 60 mL/min/1.73 m2. For individuals with CKD, the need for a treatment change was defined as not taking an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker or having blood pressure levels of 140/90 mm Hg or greater. For individuals with CKD who also had diabetes, the need for a treatment change was also defined as having hemoglobin A1c levels of 8% or greater or fasting glucose levels of 178.4 mg/dL (9.9 mmol/L) or greater. Case finding was defined as testing for CKD only in adults with hypertension or diabetes. Among 126 242 adults screened for CKD, there were 47 204 patients in the China cohort, 9817 patients in the India cohort, 51 137 patients in the Mexico cohort, 2441 patients in the Senegal cohort, and 15 643 patients in the US cohort. The mean age of participants was 49.6 years (95% CI, 49.5-49.7 years) in the China cohort, 42.9 years (95% CI, 42.6-43.2 years) in the India cohort, 51.6 years (95% CI, 51.5-51.7 years) in the Mexico cohort, 48.2 years (95% CI, 47.5-48.9 years) in the Senegal cohort, and 47.3 years (95% CI, 46.6-48.0 years) in the US cohort. The proportion of women was 57.3% (95% CI, 56.9%-57.7%) in the China cohort, 53.4% (95% CI, 52.4%-54.4%) in the India cohort, 68.8% (95% CI, 68.4%-69.2%) in the Mexico cohort, 56.0% (95% CI, 54.0%-58.0%) in the Senegal cohort, and 51.9% (51.0%-52.7%) in the US cohort. The prevalence of CKD was 2.5% (95% CI, 2.4%-2.7%) in the China cohort, 2.3% (95% CI, 2.0%-2.6%) in the India cohort, 10.6% (95% CI, 10.3%-10.9%) in the Mexico cohort, 13.1% (95% CI, 11.7%-14.4%) in the Senegal cohort, and 6.8% (95% CI, 6.2%-7.5%) in the US cohort. Screening for CKD was associated with the identification of additional adults whose treatment would change (beyond those identified by measuring blood pressure and glycemia) per 1000 adults: China: 8 adults (95% CI, 8-9 adults); India: 5 adults (95% CI, 4-7 adults); Mexico: 26 adults (95% CI, 24-27 adults); Senegal: 59 adults (95% CI, 50-69 adults); and the US: 19 adults (95% CI, 16-23 adults). Case finding was associated with the identification of 46.2% (95% CI, 45.1%-47.4%) to 86.4% (95% CI, 85.4%-87.3%) of individuals with CKD depending on the country, an increase in the proportion of individuals requiring a treatment change by as much 89.6% (95% CI, 80.4%-99.3%) in the US, and a decrease in the proportion of individuals needing GFR measurements by as much as 57.8% (95% CI, 56.3%-59.3%) in the US. This study found that most additional individuals with CKD identified by population-based screening programs did not need a change in treatment compared with a strategy of measuring blood pressure and assessing glycemia and that case finding was more efficient than screening for early detection of CKD.

Performance of Diabetes and Kidney Disease Screening Scores in Contemporary United States and Korean Populations.

BackgroundRisk assessment tools have been actively studied, and they summarize key predictors with relative weights/importance for a disease. Currently, standardized screening scores for type 2 diabetes mellitus (DM) and chronic kidney disease (CKD)—two key global health problems—are available in United States and Korea. We aimed to compare and evaluate screening scores for DM (or combined with prediabetes) and CKD, and assess the risk in contemporary United States and Korean populations.MethodsFour (2×2) models were evaluated in the United States-National Health and Nutrition Examination Survey (NHANES 2015–2018) and Korea-NHANES (2016–2018)—8,928 and 16,209 adults. Weighted statistics were used to describe population characteristics. We used logistic regression for predictors in the models to assess associations with study outcomes (undiagnosed DM and CKD) and diagnostic measures for temporal and cross-validation.ResultsKorean adult population (mean age 47.5 years) appeared to be healthier than United States counterpart, in terms of DM and CKD risks and associated factors, with exceptions of undiagnosed DM, prediabetes and prehypertension. Models performed well in own country and external populations regarding predictor-outcome association and discrimination. Risk tests (high vs. low) showed area under the curve >0.75, sensitivity >84%, specificity >45%, positive predictive value >8%, and negative predictive value >99%. Discrimination was better for DM, compared to the combined outcome of DM and prediabetes, and excellent for CKD due to age.ConclusionFour easy-to-use screening scores for DM and CKD are well-validated in contemporary United States and Korean populations. Prevention of DM and CKD may serve as first-step in public health, with these self-assessment tools as basic tools to help health education and disparity.

Impact of point-of-care screening for hypertension, diabetes and progression of chronic kidney disease in rural Manitoba Indigenous communities.

BACKGROUND:In 2013–2015, we conducted point-of-care screening for hypertension, diabetes and chronic kidney disease in rural and remote Indigenous communities in Manitoba, Canada. In this study, we aimed to determine whether optimal follow-up care was provided, defined as proportion of individuals with appropriate kidney disease laboratory testing, medication prescriptions and physician visits.METHODS:We linked screening data from participants to provincial administrative data sets to evaluate whether frequencies of laboratory testing, prescriptions of disease-modifying medications, and primary care and nephrology visits differed in the 18 months before and after screening. We also conducted a propensity score matching analysis to compare outcomes between screened and unscreened adults.RESULTS:Of 1353 adults who received the screening intervention and who had complete administrative data available, 44% were at risk of kidney failure at screening. Among these individuals, frequencies of comprehensive laboratory testing (estimated glomerular filtration rate and urine albumin to creatinine ratio) improved by 17.0% (95% confidence interval [CI] 11.5 to 22.5), anti-hyperglycemic medications improved by 4.4% (95% CI 1.0 to 7.8), and nephrology visits for participants meeting referral criteria improved by 5.9% (95% CI 3.4 to 8.5). We observed significant improvements in laboratory testing, antihyperglycemic medications and nephrology visits in the screened group compared with the 1:1 matched comparison group.INTERPRETATION:Point-of-care screening programs in rural and remote Indigenous communities are adaptable methods for increasing awareness, monitoring risk and treating chronic diseases. Interventions such as the development of a national screening program could improve chronic disease care in high-risk populations.

Retinal Vascular Signs as Screening and Prognostic Factors for Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Current Evidence.

Background: The substantial burden of kidney disease fosters interest in new ways of screening for early disease diagnosis, especially by non-invasive imaging. Increasing evidence for an association between retinal microvascular signs and kidney disease prompted us to investigate the relevant current literature on such an association systematically by performing a meta-analysis of our findings. Methods: We scrutinized the current literature by searching PubMed and Embase databases from for clinical studies of the association between retinal microvascular signs and prevalent or incident kidney disease. After excluding cases that did not meet our criteria, we extracted relevant data from 42 published studies (9 prospective, 32 cross-sectional, and 1 retrospective). Results: Our investigation yielded significant associations between retinal vascular changes (including retinopathy and retinal vascular diameter) and kidney dysfunction (including chronic kidney disease (CKD), end-stage renal disease (ESRD), albuminuria, and estimated glomerular filtration rate (eGFR) decline). According to our meta-analysis, retinopathy was associated with ESRD (hazard ratio (HR) 2.12 (95% confidence interval CI; 1.39–3.22)) and with CKD prevalence in the general population (odds ratio (OR) 1.31 (95% CI; 1.14–1.50)), and specifically in type 2 diabetic patients (OR 1.68 (95% CI; 1.68–2.16)). CRAE was associated with prevalent CKD (OR 1.41 (95% CI; 1.09–1.82)). Conclusions: Our findings suggest that the retinal microvasculature can provide essential data about concurrent kidney disease status and predict future risk for kidney disease development and progression.

Screening, Monitoring, Prevention, and Treatment Strategies for Chronic Kidney Disease in Patients with Type 2 Diabetes

Diabetes is a major risk factor for chronic kidney disease (CKD), and an estimated 20–40% of people with diabetes have evidence of CKD (109,201–205). In people with type 1 diabetes, CKD usually develops ≥10 years after diagnosis of diabetes. Because the exact time of onset of type 2 diabetes is often unclear and many patients may have had the condition for several years before diagnosis, CKD can manifest at diagnosis of type 2 diabetes.

63-OR: Focused Educational Screening Improves Knowledge of Diabetes as a Leading Risk Factor for Chronic Kidney Disease

Background: Diabetes is the leading cause of chronic kidney disease (CKD) and a major risk factor in the progression of kidney failure or end-stage kidney disease. An estimated 34.2 million Americans have diabetes, and 1 in 3 adults with diabetes may have CKD, many of whom do not know they have it. Interventions to increase CKD awareness and its complications may help promote early testing and identification among adults with diabetes. The American Kidney Fund (AKF) developed a 5-minute CKD education session and focused this intervention in the District of Columbia-Maryland-Virginia (DMV) metropolitan area. Methods­: In 2020, AKF administered a 5-item questionnaire at two AKF kidney disease screening events to assess CKD knowledge before and after 5-minute CKD education sessions. Individuals demonstrating CKD risk factors, including self-reported history of diabetes or elevated blood sugar level results, attended the education sessions. We compared responses from 129 participants and performed a paired samples t-test to determine the education sessions’ effectiveness in improving CKD knowledge. Results: The average pre-post scores increased from 57% to 89% (t(128)=10.65, p&amp;lt;0.001), with the largest gains in understanding the definition of CKD (11% to 86%, t(128)=17.62, p&amp;lt;0.001). There was a significant difference in pre-post scores for identifying diabetes and high blood pressure as the top risk factors for CKD (49% to 86%, t(128)=6.62, p&amp;lt;0.001). For the best ways to prevent CKD, keeping a healthy blood sugar level and healthy blood pressure level was also significant (65% to 89%, t(128)=4.91, p&amp;lt;0.001). Conclusion: Our study demonstrated low awareness of CKD risk factors. Educational sessions are effective for improving CKD knowledge and increasing awareness about diabetes as a major risk factor. Our study supports the expansion of CKD-related educational programs for populations at high risk for CKD. Disclosure L. Vo: None. M. Paris: None. M. Alawode: None. M. Spigler: None.

Screening of Kidney Disease in Asymptomatic Female College Students by Urine Dipstick Method

Introduction Urine examination by urine dipstick method is a useful tool to identify asymptomatic individual for kidney disease. A urine dipstick analysis was conducted on world kidney day to determine the urine abnormalities among asymptomatic female college students.&#x0D; MethodsA cross-sectional study was carried out in a government female college in Kathmandu Nepal. Three hundred asymptomatic female students participated in this study. Fresh midstream urine samples were obtained and tested by urine dipstick method. Random Blood glucose was monitored with glucometer. Blood pressure was measured by manual sphynomanometer.&#x0D; ResultsThe mean age of the female students was 22.62±2.686 years. Fifteen participants (5%) were found positive for proteinuria and only 1% of participants had glycosuria. The systolic blood pressure of &gt;120 mm Hg was present in 14% of participants while 5% of participants had diastolic blood pressure of &gt;90mm Hg. Participants who were found to have urinary proteinuria detected had both systolic and diastolic blood pressure increased. Only 8% of the participants had random blood sugar of &gt;140 mg/dl.&#x0D; ConclusionUrinary abnormalities like proteinuria and glycosuria in asymptomatic female students has significant prevalence. Systemic prehypertension and hypertension has alarming rates among adolescents. Hence, screening for blood pressure and early detection of renal disorders will lead to effective interventions and possibly reduce the burden of renal diseases.

MO1042SCREENING FOR CHRONIC KIDNEY DISEASE IN PATIENTS WITH HIGH BLOOD PRESSURE: A SURVEY OF TRAINEES’ ATTITUDES AND PRACTICES IN MOROCCO

Abstract Background and Aims High blood pressure is a leading cause of end stage renal disease (ESRD). However; early detection of chronic kidney disease (CKD) delays progression of kidney failure and reduces the risk of cardiovascular complications. Therefore, the aim of our study was to assess the attitudes and practices of interns and residents regarding screening for chronic kidney disease in patients with high blood pressure at a Moroccan University hospital. Methods A cross-sectional survey was conducted among 100 medical interns and residents at Mohammed VI university hospital of Marrakesh. Results Overall, 82% of the trainees who responded (response rate 89%) stated that they were sensitized to screening for chronic kidney disease in patients with high blood pressure, mainly during their medical studies. However, trainees who systematically monitor renal function in their hypertensive patients did not exceed 13%. While 34% of respondents preferred to refer them to a cardiologist or a nephrologist, and 35% looked for renal impairment only in special situations, dominated by the presence of diabetes or severe hypertension. The main tests used by the participants for monitoring kidney function were represented by blood renal function (100%) and 24h urine protein (61%). Microalbuminuria was mentioned by only 23% of the trainees. The major limits reported by the surveyed physicians were the lack of experience and the non- compliance of patients. Conclusion Our findings revealed inappropriate practices among our training doctors concerning the screening of CKD in hypertensive patients. Therefore, more educational workshops and courses are recommended, especially in low-income countries where access to dialysis is not always affordable.

Screening for Chronic Kidney Disease in Relatives of Hemodialysis Patients

Objective: To estimate the prevalence and socioeconomic characteristics of Chronic Kidney Disease (CKD) in first and second-degree relatives of patients on hemodialysis Method: A questionnaire was applied on socioeconomic conditions, lifestyle, and personal pathological background. The formula of CKD-EPI and/or proteinuria greater than or equal to 1+ was used to characterize CKD. Analysis using the logistic regression model. Results: 408 individuals were evaluated and 12% had CKD. 6.61% had a glomerular filtration rate (GFR) ≤ 60 mL / min / 1.73 m2 and 5.39% proteinuria in the urine. The variables associated with the presence of CKD were age (OR = 1,60; 95% IC = 1,31-1,96), PAS (OR: 1,69; 95% IC: 1,24-2,28), PAD (OR: 1,52; 95% IC: 1,18- 1,96) and blood glucose (OR: 2,03; 95% IC: 1,38-2,99). Conclusion: It is necessary to implement routines for systematic evaluation that prevent or delay the loss of renal function, in addition to measures that improve the pre-dialysis clinical conditions of this population. Keywords: Chronic kidney disease, Family, Glomerular filtration rate. DOI: 10.7176/RHSS/11-10-06 Publication date: May 31 st 2021

Importance of Early Screening and Diagnosis of Chronic Kidney Disease in Patients with Type 2 Diabetes.

It is estimated that one in ten people in the USA have diabetes. Approximately 40% of those with diabetes also develop chronic kidney disease (CKD), which in turn increases their risk of developing cardiovascular disease. Evidence-based recommendations for the treatment of patients with type 2 diabetes (T2D) and concomitant CKD are provided by several medical societies, including the American Diabetes Association (ADA), but in real life are only carried out in fewer than 50% of individuals for whom they are recommended. Screening for CKD is recommended using the spot urine albumin-to-creatinine ratio and estimated glomerular filtration rate in all patients with T2D at the time of diagnosis, and at least annually thereafter. Screening enables early CKD diagnosis, counseling, pharmacologic intervention and, when appropriate, referral to a nephrologist. The ADA guidelines recommend good glycemic and blood pressure control and the use of medications that are kidney protective. Medications shown to slow progression of CKD include renin–angiotensin system inhibitors, sodium–glucose cotransporter-2 inhibitors, glucagon-like peptide 1 receptor agonists and, more recently, non-steroidal mineralocorticoid receptor antagonists. Novel agents with different mechanisms of action are also in development that have the potential to further slow or prevent disease progression when used with currently recommended therapies.

Diagnosis of Chronic Kidney Disease by Three-Dimensional Contrast-Enhanced Ultrasound Combined with Augmented Reality Medical Technology.

Chronic kidney disease is a worldwide clinical and public health problem. As a risk factor for cardiovascular and cerebrovascular diseases, the disease has gradually become one of the causes of morbidity and death. As a routine method of screening for kidney disease, ultrasound is very important in improving the rate of early detection and accuracy of chronic kidney disease. This article explores the value of applying 3D ultrasound in conjunction with augmented reality medical technology in chronic kidney disease, observing changes in kidney tumor at different stages with percutaneous 3D ultrasound in patients with chronic kidney disease. Volunteers with chronic kidney disease were selected for this experiment. Among them, 160 males and 140 females were diagnosed as chronic kidney disease by clinical or renal pathological biopsy, and they all met the K/DOQI diagnostic criteria for chronic kidney disease. The selected subjects met the criteria and were divided into 5 groups, each with 60 patients, to explore the correlation of properties such as three-dimensional ultrasound kidney volume in different stages of chronic kidney disease. Experiments have shown that, with the increase in the stages of chronic kidney disease, the elasticity and volume of the renal parenchyma decrease, and the resistance index of the renal artery becomes larger, P < 0.05; the difference is statistically significant, indicating that the elasticity of the renal parenchyma is associated with chronic kidney disease. The stage is negatively correlated, and the resistance index of the renal artery is positively correlated with the stage of chronic kidney disease. That is, as the stage of chronic kidney disease increases, the three-dimensional volume of the kidney shows a decreasing trend and the resistance index of the renal artery shows an increasing trend. Speed shows a declining trend and there is some correlation between the three.

Adherence to Chronic Kidney Disease Screening Guidelines Among Patients With Type 2 Diabetes in a US Administrative Claims Database

ObjectiveTo examine the screening rates for kidney damage and function among patients with type 2 diabetes (T2D) and chronic kidney disease stage at diabetes diagnosis using a US administrative claims database. Patients and MethodsThis cohort study used a claims database enriched with laboratory results data. Patients with T2D (defined as 1 inpatient or 2 outpatient claims for diabetes), aged 18 years or older, and with at least 1 year of follow-up enrollment were identified. Patients with type 1 diabetes, kidney disease, or other related conditions at baseline were excluded. We estimated screening rates using laboratory orders for serum creatinine and estimated glomerular filtration rate (eGFR) measurement and urine albumin to creatinine ratio (UACR). Chronic kidney disease severity was reported using the Kidney Disease: Improving Global Outcomes classification based on laboratory results. ResultsA total of 1,881,447 patients with T2D were eligible for analysis. Mean ± SD age was 63.1±13.1 years; 947,150 patients (50.3%) were male. Serum creatinine tests were ordered within 14 days of the index date among 290,722 patients of 622,915 (46.7%) patients with newly-recognized T2D. Overall, 1,595,964 patients (84.8%) had at least one serum creatinine test ordered during the 1-year follow-up period. Fewer patients received a UACR test during follow-up (814,897 [43.3%]). Less than half of all patients with T2D received a laboratory test order for both serum creatinine and urine albumin measurements during the follow-up period. ConclusionPhysicians treating patients with diabetes are selectively adhering to chronic kidney disease screening guidelines, as indicated by high rates of eGFR testing, but less frequent UACR testing. Despite recommendations to monitor both eGFR and UACR, less than half of patients were screened for albuminuria during the 1-year follow-up.

Albuminuria, proteinuria, and dipsticks: novel relationships and utility in risk prediction.

Albuminuria is associated with progression of kidney disease and is the accepted gold standard for screening, staging, and prognostication of chronic kidney disease. This review focuses on current literature that has explored applications of albuminuria as a surrogate outcome, variable used in kidney failure risk prediction for novel populations, and variable that may be predicted by other proteinuria measures. Change in albuminuria shows promise as a surrogate outcome for kidney failure, which may have major implications for trial design and conduct. The kidney failure risk equation (KFRE) has been validated extensively to date and has now been applied to pediatric patients with kidney disease, advanced age, different causes of kidney disease, various countries, and those with prior kidney transplants. As albumin-to-creatinine ratios (ACRs) are not always available to clinicians and researchers, two recent studies have independently developed equations to estimate ACR from other proteinuria measures. The utility of albuminuria and the KFRE continues to grow in novel populations. With the ability to convert more widely available (and inexpensive) proteinuria measures to ACR estimates, the prospect of incorporating kidney failure risk prediction into routine care within economically challenged healthcare jurisdictions may finally be realized.

Screening of Chronic Kidney Disease in Kafr-Elsheikh University, Egypt

Chronic Kidney Disease (CKD) represents a significant public health problem, with nearly 20 million people in the United States having kidney damage or reduced kidney function, most patients with kidney disease are asymptomatic, underling the need for routine screening of all patients who are at risk for developing kidney disease. Screening of unending kidney sickness around Obviously solid people in Kafr- Elsheikh university, egypt. Those parameters contain :Full history taking including: personal history, secret word history, family history Furthermore medication historical backdrop. Physical examination including: blood pressure, particular figure weight, tallness Also constitution impostor list. Furthermore lab investigations Concerning illustration serum creatinine, urinary protein Eventually Tom's perusing dipstike Also HbA1c. Over 13. 8% from claiming Obviously solid subjects needed CKD (62. 2% needed phase I, 33. 8% required phase II, 4% needed stage III). CKD might have been higher around guys over females. Stoutness might have been An hazard component to CKD and the rate of stout around CKD patients might have been 48%, population i stoutness might have been 47. 3%, population ii Weight 0. 7%. Overweight 29. 1% What's more ordinary weight 22. 9%. Those imply from claiming BMI Around CKD patients might have been 28. 3± 4. 2. Higher recurrence about hypertension were fundamentally connected with CKD patients 33. 8% when contrasted with non CKD subjects 5. 1%. Diabetics might have been diagnosed around 5. 6% from claiming every last bit examined subjects. Higher recurrence about diabetics were altogether connected with CKD The point when contrasted with non CKD subjects. Those rate of CKD needed diabetics might have been (26%) same time CKD required pre diabetics might have been (25%) about CKD patients. Higher urinary protein evaluations were essentially connected with CKD.

Screening of bacterial kidney disease in the North-West region of the Russian Federation

Our country has all potential for development of an aquaculture as one of sectors of agriculture, due to a huge number of fresh water areas and the extended line of the seas. Bacterial kidney disease, a chronic disease in the Salmonidae family, causes significant damage to aquaculture development. Modern proposals for the use of various antibiotics and chemotherapeutic drugs do not bring a significant effect to control the spread of this disease, and due to the peculiarity of the pathogenesis of the disease, the development of an effective vaccine against bacterial kidney disease is currently difficult, therefore the most effective method of controlling and preventing the disease is early diagnosis of the disease. The article discusses the results of exploratory studies of bacterial kidney disease in fish-breeding enterprises of the North-West region of the Russian Federation for the period from March 2019 to March 2020.

Screening, prevalence, treatment and control of kidney disease in patients with type 1 and type 2 diabetes in low-to-middle-income countries (2005\u20132017): the International Diabetes Management Practices Study (IDMPS)

Aims/hypothesisDiabetes is the leading cause of kidney disease worldwide. There is limited information on screening, treatment and control of kidney disease in patients with diabetes in low-to-middle-income countries (LMICs).MethodsThe International Diabetes Management Practices Study is an ongoing, non-interventional study of clinical profiles and practices among patients receiving outpatient care mainly by internal medicine physicians and endocrinologists in LMICs. We examined screening, prevalence, treatment and control of kidney disease across seven waves (W) of data collection between 2005 and 2017.ResultsAmong 15,079 patients with type 1 and 66,088 patients with type 2 diabetes, screening for kidney disease increased between W2 and W3 followed by a plateau (type 1 diabetes: W2, 73.7%; W3, 84.1%; W7, 83.4%; type 2 diabetes: W2, 65.1%; W3, 82.6%; W7, 86.2%). There were also decreasing proportions of patients with microalbuminuria (type 1 diabetes: W1, 27.1%; W3, 14.7%; W7, 13.8%; type 2 diabetes: W1, 24.5%; W3, 12.6%; W7, 11.9%) and proteinuria (type 1 diabetes: W1, 14.2%; W3, 8.7%; W7, 8.2%; type 2 diabetes: W1, 15.6%; W3, 9.3%; W7, 7.6%). Fewer patients were reported as receiving dialysis for both type 1 diabetes (W2, 1.4%; W7, 0.3%) and type 2 diabetes (W2, 0.9%; W7, 0.2%) over time. While there was no change in mean HbA1c or prevalence of diagnosed hypertension (type 1 diabetes: W1, 22.7%; W7, 19.9%; type 2 diabetes: W1, 60.9%; W7, 66.2%), the use of statins had increased among patients diagnosed with dyslipidaemia (type 1 diabetes: W1, 77.7%; W7, 90.7%; type 2 diabetes: W1, 78.6%; W7, 94.7%). Angiotensin II receptor blockers (type 1 diabetes: W1, 18.0%; W7, 30.6%; type 2 diabetes: W1, 24.2%; W7, 43.6%) were increasingly used over ACE inhibitors after W1 (type 1 diabetes: W1, 65.0%; W7, 55.9%; type 2 diabetes: W1, 55.7%, W7, 41.1%) among patients diagnosed with hypertension.Conclusions/interpretationIn LMICs, real-world data suggest improvement in screening and treatment for kidney disease in patients with type 1 and type 2 diabetes attending non-nephrology clinics. This was accompanied by decreasing proportions of patients with microalbuminuria and proteinuria, with fewer patients who reported receiving dialysis over a 12-year period.Graphical abstract