Gheewala, PA and Zaidi, STR and Jose, MD and Bereznicki, L and Peterson, GM and Castelino, RL, Effectiveness of targeted screening for chronic kidney disease in the community setting: a systematic review, Journal of Nephrology, 31, (1) pp. 27-36. ISSN 1724-6059 (2018) [Refereed Article]
ę Italian Society of Nephrology 2017
Background: Targeted screening interventions for chronic kidney disease (CKD) are increasingly being implemented in various community settings. However, the overall success of these programs is uncertain. Therefore, the aim of this review is to determine whether targeted screening is effective in detecting people with undiagnosed CKD.
Methods: We performed a systematic literature review, and included studies of targeted screening intervention implemented in any community-based setting. Studies were required to have targeted people aged ≥ 18 years, and multiple CKD risk factors from the following: diabetes, hypertension, cardiovascular disease and family history of kidney disease. The outcome measures were percentages of participants with positive screening test results and diagnosed with CKD at follow-up.
Results: Nine studies met the inclusion criteria. Eight studies reported the percentage of participants with positive screening test results, which ranged from 7 to 60.3%. Only two studies repeated the diagnostic tests to detect CKD, and confirmed the chronicity of CKD in 20.5 and 17.1% of screened participants. The most commonly used screening tests were albumin creatinine ratio (≥ 3.4 mg/mmol), and estimated glomerular filtration rate (eGFR) (< 60 ml/ min/1.73 m2). All studies classified CKD stage 3 and above based on eGFR alone. Characteristics of the interventions responsible for inconsistencies in the outcome measures included CKD risk factors targeted, and screening tests used to detect CKD.
Conclusions: This systematic review found significant variation in the methods that were used to detect CKD, with the majority of studies reporting results based on only single albuminuria or eGFR values. Future targeted screening programs should appropriately use the 2012 KDIGO guidelines in order to detect CKD, which is necessary to determine the benefit of these programs when implemented in community-settings.
|Item Type:||Refereed Article|
|Keywords:||chronic kidney disease, targeted screening, community setting, early detection, effectiveness, systematic review|
|Research Division:||Medical and Health Sciences|
|Research Group:||Pharmacology and Pharmaceutical Sciences|
|Research Field:||Clinical Pharmacy and Pharmacy Practice|
|Objective Group:||Other Health|
|Objective Field:||Health not elsewhere classified|
|Author:||Gheewala, PA (Miss Pankti Gheewala)|
|Author:||Zaidi, STR (Dr Tabish Razi Zaidi)|
|Author:||Jose, MD (Professor Matthew Jose)|
|Author:||Bereznicki, L (Professor Luke Bereznicki)|
|Author:||Peterson, GM (Professor Gregory Peterson)|
|Author:||Castelino, RL (Dr Ronald Castelino)|
|Year Published:||2018 (online first 2017)|
|Web of Science® Times Cited:||6|
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