Early Identification of CKD-A Scoping Review of the Global Populations

Ikechi G Okpechi^{1

2

3}, Fergus J Caskey⁴, Abduzhappar Gaipov⁵, Elliot K Tannor^{6

7}, Jean Jacques Noubiap⁸, Emmanuel Effa^{9

10}, Udeme E Ekrikpo¹¹, Laura N Hamonic¹², Gloria Ashuntantang¹³, Aminu K Bello¹, Jo-Ann Donner¹⁴, Ana E Figueiredo¹⁵, Reiko Inagi¹⁶, Magdalena Madero¹⁷, Charu Malik¹⁴, Monica Moorthy¹⁴, Roberto Pecoits-Filho^{18

19}, Vladimir Tesar²⁰, Adeera Levin²¹, Vivekanand Jha^{22

23

24}

Affiliations

¹ Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
² Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa.
³ Kidney and Hypertension Research Unit, University of Cape Town, Cape Town, South Africa.
⁴ Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
⁵ Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan.
⁶ Renal Unit, Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
⁷ Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
⁸ Centre for Heart Rhythm Disorders, The University of Adelaide, Adelaide, South Australia, Australia.
⁹ Department of Medicine, University of Calabar, Calabar, Nigeria.
¹⁰ Department of Internal Medicine, Edward Francis Small Teaching Hospital, Banjul, The Gambia.
¹¹ Department of Internal Medicine, University of Uyo, Uyo, Nigeria.
¹² John W. Scott Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada.
¹³ Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
¹⁴ International Society of Nephrology, Brussels, Belgium.
¹⁵ School of Health Science and Life-Nursing School, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
¹⁶ Division of Chronic Kidney Disease Pathophysiology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.
¹⁷ Department of Medicine, Division of Nephrology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
¹⁸ Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA.
¹⁹ School of Medicine, Pontificia Universidade Catolica do Parana, Curitiba, Brazil.
²⁰ Department of Nephrology, 1st Faculty of Medicine, General University Hospital, Charles University, Prague, Czech Republic.
²¹ Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
²² George Institute for Global Health, University of New South Wales, New Delhi, India.
²³ School of Public Health, Imperial College, London, UK.
²⁴ Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India.

PMID: 35685314
PMCID: PMC9171699
DOI: 10.1016/j.ekir.2022.03.031

Early Identification of CKD-A Scoping Review of the Global Populations

Ikechi G Okpechi et al. Kidney Int Rep. 2022.

. 2022 Apr 6;7(6):1341-1353.

doi: 10.1016/j.ekir.2022.03.031. eCollection 2022 Jun.

Authors

Affiliations

¹ Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
² Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa.
³ Kidney and Hypertension Research Unit, University of Cape Town, Cape Town, South Africa.
⁴ Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
⁵ Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan.
⁶ Renal Unit, Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
⁷ Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
⁸ Centre for Heart Rhythm Disorders, The University of Adelaide, Adelaide, South Australia, Australia.
⁹ Department of Medicine, University of Calabar, Calabar, Nigeria.
¹⁰ Department of Internal Medicine, Edward Francis Small Teaching Hospital, Banjul, The Gambia.
¹¹ Department of Internal Medicine, University of Uyo, Uyo, Nigeria.
¹² John W. Scott Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada.
¹³ Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
¹⁴ International Society of Nephrology, Brussels, Belgium.
¹⁵ School of Health Science and Life-Nursing School, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
¹⁶ Division of Chronic Kidney Disease Pathophysiology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.
¹⁷ Department of Medicine, Division of Nephrology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
¹⁸ Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA.
¹⁹ School of Medicine, Pontificia Universidade Catolica do Parana, Curitiba, Brazil.
²⁰ Department of Nephrology, 1st Faculty of Medicine, General University Hospital, Charles University, Prague, Czech Republic.
²¹ Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
²² George Institute for Global Health, University of New South Wales, New Delhi, India.
²³ School of Public Health, Imperial College, London, UK.
²⁴ Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India.

PMID: 35685314
PMCID: PMC9171699
DOI: 10.1016/j.ekir.2022.03.031

Abstract

Introduction: Decisions on whether to screen for chronic kidney disease (CKD) or not remain contentious in nephrology. This study provides a global overview of early CKD identification efforts.

Methods: Guidelines for scoping reviews were followed and studies were identified by searching MEDLINE, EMBASE, Cochrane Library, CINAHL, ISI Web of Science, and PsycINFO. Data extracted from included studies focused on the following 4 themes: study population, measurement methods, interventions used, and available policies.

Results: We identified 290 CKD screening and detection programs from 83 countries. Overall sample size was 3.72 million (North East Asia: 1.19 million), detection of CKD was the aim in 97.6%, 63.1% used population-based screening methods, and only 12.4% were in rural populations. Reported CKD prevalence (stages 3-5) was higher in targeted- (14.8%) than population-based studies (8.0%). Number of persons needed to screen (NNS) to identify 1 case was also lower in targeted studies (7 vs. 13). Single measurements (80%) and the combination of estimation of glomerular filtration rate with a urine test (albuminuria/proteinuria) (71.4%) were frequently used to detect CKD. Only 2.8% of studies included an intervention such as pharmacotherapy in identified cases. Policies on early identification were available in 30.1% of countries included.

Conclusion: Methods for early CKD identification vary worldwide, often leading to wide variations in the reported prevalence. Efforts to standardize measurement methods for early detection focusing on high-risk populations and ensuring appropriate interventions are available to those identified with CKD will improve the value of programs and improve patient outcomes.

Keywords: chronic kidney disease; early detection; estimated glomerular filtration rate; intervention; measurement; screening.

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Figures

**Figure 1**
Demographic features of included studies by ISN regions. CKD, chronic kidney disease; NIS, newly independent states.

**Figure 2**
Features of early detection studies based on screening method. C-G, Cockcroft-Gault; CKD-EPI, Chronic Kidney Disease-Epidemiology Collaboration; eGFR, estimated glomerular filtration rate; MDRD, Modification of Diet in Renal Disease. ∗Represents urine dipsticks only or urine albumin-to-creatinine ratio only.

See this image and copyright information in PMC

References

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Early Identification of CKD-A Scoping Review of the Global Populations

Affiliations

Early Identification of CKD-A Scoping Review of the Global Populations

Authors

Affiliations

Abstract

Figures

References

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