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Please note that you are viewing an archived section from 2019 and some content may be unavailable. To unlock all content for 2019, please visit the archives.

Abstract: SA-PO860

An Innovative, Community-Based Screening Strategy Identifies High Rates of Advanced CKD in Asymptomatic Individuals Living in a Low-Income, Largely African-American Community

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Montgomery, Aisha H., Baylor Scott & White Health, Dallas, Texas, United States
  • Kitzman, Heather, Baylor Scott & White Health, Dallas, Texas, United States
  • Parnell, Winfred C., Baylor Scott & White, Dallas, Texas, United States
  • Halloran, Kenneth, Baylor Scott & White Health, Dallas, Texas, United States
  • Mamun, Abdullah A., Baylor Scott & White Health, Dallas, Texas, United States
  • Wesson, Donald E., Baylor Scott and White Health and Wellness Center, Dallas, Texas, United States
Background

The USRDS most recently (2018) reported a statistically significant increasing prevalence of more advanced stages (3-5) of chronic kidney disease (CKD). Individuals with early CKD are generally asymptomatic and so remain largely unidentified until presenting to health systems with symptomatic, far advanced, CKD at which time kidney-protective interventions offer limited benefit to delay progression to end-stage kidney disease. Reducing prevalence of advanced CKD must include proactive screening to identify asymptomatic individuals with early CKD while in their routine living environments.

Methods

As part of a grant (R21DK113440) we tested an innovative screening strategy to identify asymptomatic individuals with CKD through community-level screening in settings trusted by community members including churches, community-based organizations, and community events in low-income, largely African American communities that studies show to be at high CKD risk. We met with these community-based organizations to describe our study testing the effectiveness of education regarding preparation of provided fruits and vegetables compared to providing the fruits and vegetables alone. We then dispatched the screening team to those that agreed to allow dipstick measurements of urine albumin concentration (Ualb).

Results

To date, we screened 282 participants, finding 83% (N= 234) with albumin > 30 mg/l, the level designated as “positive”. The first 55 individuals who completed measures had mean (SD) age of 55.4 (11.1) years, 30.9% were male, and had mean eGFR (CKD-EPI creatinine-based) of 50.3 (13.2) ml/min/1.73m2 with 0% CKD 1, 20% CKD 2, 76% CKD 3a/b, and 2% CKD 4. This proportion of measured participants with CKD stage 3 was much higher than anticipated based on NHANES 2001 – 2016 data (~47%).

Conclusion

This innovative screening strategy found high rates of both albuminuria and subnormal eGFR in asymptomatic individuals living in communities at high CKD risk through leveraging trusted community organizations. The strategy should be explored further to identify asymptomatic individuals with early CKD who are candidates for kidney protective interventions designed to reduce the increasing prevalence of advanced stages of CKD.

Funding

  • NIDDK Support