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Kidney Week

Abstract: INFO14-FR

Optimal Approaches to CKD Case Finding in Indigenous Communities: The Kidney Check Program

Session Information

  • Informational Posters - II
    November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

Authors

  • Wilson, Lucy M., Seven Oaks General Hospital, Winnipeg, Manitoba, Canada
  • Ferguson, Thomas W., University of Manitoba, Winnipeg, Manitoba, Canada
  • Tangri, Navdeep, University of Manitoba, Winnipeg, Manitoba, Canada
  • Rigatto, Claudio, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
  • Levin, Adeera, St. Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
  • Manns, Braden J., Foothills Medical Center, Calgary, Alberta, Canada
  • Harris, Heather, Can-SOLVE CKD, Vancouver, British Columbia, Canada
  • Komenda, Paul, University of Manitoba, Winnipeg, Manitoba, Canada
Description

Background
Indigenous Canadians have high rates of many chronic diseases, including diabetes and chronic kidney disease (CKD). Moreover, they have disproportionately high rates of kidney failure, with increased burden in rural and remote communities that often have a lack of access to medical services. Earlier identification of chronic disease risk factors and appropriate risk stratification using tools such as the Kidney Failure Risk Equation (KFRE) may help reduce progression through earlier lifestyle and pharmacologic interventions known to reduce progression.
Methods
The objective of this study is to implement a large national CKD screening, triage, and treatment program in rural and remote indigenous communities across four Canadian provinces (ages 10-85). Our aim is to answer 2 questions: (1) what is the prevalence of CKD and contributing risk factors in Canada’s indigenous communities?; and (2) is a national universal screening program viable, adaptable, and cost-effective for the prevention of kidney failure in indigenous Canadians? The primary outcome of interest is the combined prevalence of at least one unmanaged risk factor of diabetes (elevated hemoglobin A1C), hypertension (elevated blood pressure), or CKD (abnormal eGFR or urine ACR). The program will use point-of-care testing equipment to screen individuals for CKD, diabetes, and hypertension. Patients will be triaged and referred to appropriate follow up care. An overview of the proposed screening paradigm is presented in the accompanying figure.
Anticipated Results
We hypothesize that we will identify a prevalence of chronic disease and CKD related risk factors that is disproportionately high in comparison to the general population. Future studies will examine long term outcomes of those screened to determine real world effectiveness of this intervention through linking with administrative data sources.

Funding

  • Canadian Institute for Health Research (CIHR) Research Manitoba Kidney Foundation of Canada Provincial Health Services Association Michael Smith Foundation for Health Research