Diagnostic Yield of Population-Based Screening for Chronic Kidney Disease in Low-Income, Middle-Income, and High-Income Countries
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Date
2021-10-04
Journal Title
Journal ISSN
Volume Title
Publisher
Jama Network Open
Abstract
IMPORTANCE 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.
OBJECTIVE 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.
DESIGN, SETTING, AND PARTICIPANTS 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.
MAIN OUTCOMES AND MEASURES The primary definition of CKD was estimated glomerular
filtration rate less than 60 mL/min/1.73m2. 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 140/90mmHg 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 178.4mg/dL (9.9 mmol/L) or greater. Case finding was
defined as testing for CKD only in adults with hypertension or diabetes.
Description
JAMA network open, 4(10), e2127396-e2127396.
Keywords
Deepa Mohan, PhD, Guillermo Garcia Garcia, MD, José Alfonso Gutiérrez Padilla,MD,MScPH, Scott Klarenbach, MD, MSc, Guillermo Navarro Blackaller, MD, Sidy Seck, MD, MPH, JinweiWang, PhD, Luxia Zhang, MD, MPH, Paul Muntner, PhD, University Cheikh Anta Diop, Senegal, CEA-AGIR
Citation
Tonelli, M., Tiv, S., Anand, S., Mohan, D., Garcia, G. G., Padilla, J. A. G., ... & Muntner, P. (2021). Diagnostic yield of population-based screening for chronic kidney disease in low-income, middle-income, and high-income countries. JAMA network open, 4(10), e2127396-e2127396.