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

Okpechi I.G. Caskey F.J. Gaipov A. Tannor E.K. Noubiap J.J. Effa E. Ekrikpo U.E. Hamonic L.N. Ashuntantang G. Bello A.K. Donner J.-A. Figueiredo A.E. Inagi R. Madero M. Malik C. Moorthy M. Pecoits-Filho R. Tesar V. Levin A. Jha V.
June 2022 Elsevier Inc.

Kidney International Reports
2022 #7 Issue 6 1341 - 1353 pp.

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.

chronic kidney disease , early detection , estimated glomerular filtration rate , intervention , measurement , screening

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

Department of Medicine
Division of Nephrology and Hypertension
Kidney and Hypertension Research Unit
Population Health Sciences
Department of Medicine
Renal Unit
Department of Medicine
Centre for Heart Rhythm Disorders
Department of Medicine
Department of Internal Medicine
Department of Internal Medicine
John W. Scott Health Sciences Library
Department of Internal Medicine and Specialties
International Society of Nephrology
School of Health Science and Life—Nursing School
Division of Chronic Kidney Disease Pathophysiology
Department of Medicine
Arbor Research Collaborative for Health
School of Medicine
Department of Nephrology
Division of Nephrology
George Institute for Global Health
School of Public Health
Prasanna School of Public Health

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