Kidney Week

Abstract: PUB122

Individuals with Unrecognized CKD Can Be Identified and Referred into Care by a Workplace Wellness Program

Session Information

• Publication Only

Category: CKD (Non-Dialysis)

• 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Iakoubova, Olga A., Quest Diagnostics, San Juan Capistrano, California, United States

Olga A. Iakoubova,

• Arellano, Andre, Quest Diagnostics, San Juan Capistrano, California, United States

Andre Arellano,

• Tong, Carmen H., Quest Diagnostics, San Juan Capistrano, California, United States

Carmen H. Tong,

• Bare, Lance A., Quest Diagnostics, San Juan Capistrano, California, United States

Lance A. Bare,

• Devlin, James J., Quest Diagnostics, San Juan Capistrano, California, United States

James J. Devlin,

• Birse, Charles E., Quest Diagnostics, San Juan Capistrano, California, United States

Charles E. Birse,

Background

Of the 30 million Americans who have chronic kidney disease (CKD), 85 percent are unaware of their disease. Once recognized, lifestyle changes and medical therapy can slow CKD progression. A workplace wellness program was modified with the aim of improving the recognition of CKD and referral into physician care. We asked whether this modified program improved management of individuals with previously unrecognized CKD.

Methods

An ongoing workplace wellness screening program provides annual estimated glomerular filtration rate (eGFR) results. Those individuals (n=402) who had an eGFR <60 mL/min/1.73 m² in 2016 were invited to participate in the CKD program. All 402 received a confirmatory eGFR test during the 2017 wellness screening program. Those who agreed to participate in the CKD program also received a urine albumin test and were offered a telephone consultation with a program physician to discuss their test results and referral into physician care. Using a limited data set of health plan claims, we compared the proportion of physician visits between participants and non-participants using a logistic regression model that adjusted for age, sex and education level.

Results

Of the individuals eligible for the CKD program, 51 percent (205/402) agreed to participate. CKD was confirmed in 51 percent (105/205) of the participants, either by repeat eGFR <60 mL/min/1.73 m² or by urine albumin to creatinine ratio (ACR) ≥30 mg/g. The comparison group consisted of the 88 of the 402 individuals who had not accepted the invitation to participate and who had an eGFR result <60 mL/min/1.73 m² in the 2017 screening program. In the 3 months following confirmatory CKD testing, 2 participants visited a nephrologist, but no non-participants did. Because of the program, one participant with low eGFR levels (eGFR=10 mL/min/1.73 m² in 2016; eGFR=3 mL/min/1.73 m² in 2017) initiated kidney dialysis. The proportion of participants who visited a physician was about 2-fold greater than non-participants (21% vs. 10%): OR 2.3, 95% CI 1.0-5.4, p=0.047; this difference was not appreciably changed after adjustment for age, sex, and education level.

Conclusion

A workplace CKD outreach program can identify individuals who will benefit from a timely referral into physician care.

Funding

• Commercial Support –