Kidney early evaluation program: a community-based screening approach to address disparities in chronic kidney disease

Abstract

The Kidney Early Evaluation Program (KEEP) is a free, community-based, kidney disease screening program designed to detect chronic kidney disease (CKD) early and promote follow-up evaluation with clinicians to ultimately improve outcomes. This program screens individuals with diabetes, hypertension, or those with a first-degree relative with diabetes, hypertension, and/or kidney disease. Data based on 89,552 KEEP participants screened in 49 states from early August 2000 until end of December 2007 disclosed a prevalence of 34% African Americans, 12.4% Hispanics, 5.6% Asian/Pacific Islanders, and 4.5% Native Americans. Compared with the random US population sample in National Health and Nutrition Examination Survey 1999 to 2006 and the US Census Bureau 2000, KEEP represented 3-fold more African Americans and Native Americans and a similar proportion of Hispanics and Asians/Pacific Islanders. Analysis of KEEP data confirm that control of CKD risk factors and awareness of CKD remains low. In conclusion, KEEP is an enriched source of populations at high risk for CKD, and control of the two major CKD risk factors, diabetes and hypertension, remains disappointingly low, especially in high-risk populations, despite disease awareness. A longitudinal component of KEEP will evaluate the impact of the program on health disparities over time and holds promise for improving awareness and possibly future management of CKD risk factors.