Kidney Week

Abstract: SA-PO862

CKD Detection Might Benefit from an Ethnic-Specific Screening Approach: Results from the HELIUS Study

Session Information

• CKD: Socioeconomic Context and Mobile Apps
  November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

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

Authors

• Huisman, Brechje, Academic Medical Centre, Amsterdam, Netherlands

Brechje Huisman,

• Van den born, Bert-jan, Academic Medical Centre, Amsterdam, Netherlands

Bert-jan Van den born,

• Agyemang, Charles, Academic Medical Centre, Amsterdam, Netherlands

Charles Agyemang,

• Snijder, Marieke, Academic Medical Centre, Amsterdam, Netherlands

Marieke Snijder,

• Vogt, Liffert, Academic Medical Centre, Amsterdam, Netherlands

Liffert Vogt,

Background

Screening for chronic kidney disease (CKD) is currently recommended for patients with a history of diabetes mellitus, hypertension or cardiovascular disease (CVD). This approach may not identify all individuals with CKD. Ethnicity, age and socio-economic status (SES) have been described to affect CKD risk and these factors may influence CKD detection in the general population. We studied whether the addition of criteria for age and socio-economic status may improve CKD detection in a multiethnic population.

Methods

Baseline data from the HELIUS study, a multiethnic cohort study conducted in the city of Amsterdam, were used. Analyses were conducted among 21,617 partcipants (mean age 44 years, 43% male) of Dutch (n=4564), South-Asian Surinamese (n=3043), African Surinamese (n=4151), Ghanaian (n=2339), Moroccan (n=3614) and Turkish (n=3906) ethnic origin. Detection success of three screening approaches was investigated in each ethnic group. Respectively, approaches I, II and III consisted of the traditional approach (i.e, screening when a history of diabetes mellitus, hypertension or CVD was present); the traditional approach combined with age >50 yr; and the traditional approach combined with low SES (i.e, none or elementary schooling only). We defined CKD as eGFR (CKD-EPI formula,< 60ml/min/1.73m²) or albuminuria (A2/A3).

Results

In our cohort, 2284 (10.6%) participants had CKD. Overall, compared to approach I, approach II increased detection success with 6.7% and approach III with 6.3%. Detection success of approach I among the ethnic groups varied from 38.8 to 70.3%. Detection improvement by using approach II and III showed ethnic specific differences. In participants of Dutch origin, approach II significantly increased the detection rate with 15.1%, while in participants of Turkish and Moroccan origin approach III significantly increased detection rates (8.9 and 14.1%, respectively).

Conclusion

Addition of age and SES criteria to the currently advised screening approach results in higher CKD detection. This improvement varies among ethnic groups. Addition of an age criteria improved detection in Dutch participants, while adding a SES criterium improved detection in Turkish and Moroccan participants. Our results may prompt for development of a different set of CKD screening criteria in a multiethnic population.