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To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

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Kidney Week

Abstract: SA-PO035

Health Inequalities in Kidney Disease: Meeting the Urgent Need to Identify Early Disease in High-Risk Communities (HIDDEN-CKD): A Feasibility Study

Session Information

Category: Diversity and Equity in Kidney Health

  • 900 Diversity and Equity in Kidney Health

Authors

  • Agyekum, Roseline Elsie, King's College London, London, United Kingdom
  • Griffiths, Kathryn, King's College London, London, United Kingdom
  • Musomba, Rachel Z., Africa Advocacy Foundation, London, United Kingdom
  • Jain, Neerja Kumari, Kidney Research UK, Peterborough, Peterborough, United Kingdom
  • Onyango, Denis O., Africa Advocacy Foundation, London, United Kingdom
  • Bramham, Kate, King's College London, London, United Kingdom

Group or Team Name

  • HIDDEN Working Group.
Background

There is a global epidemic of chronic kidney disease (CKD) and people of ethnic minority groups and those living with socioeconomic deprivation are disproportionately affected. Peer educators (PEs) are members of target demographic groups and provide culturally congruous education and support. HIDDEN-CKD explored the feasibility of using PE led kidney health screening events in South East London to increase the reach, equity and acceptability of routine healthcare interventions to identify early disease in African and Caribbean communities.

Methods

Stage 1: Public engagement to co-develop culturally appropriate CKD materials
Stage 2: PE recruitment and accredited training; engagement with local faith and non-faith community leaders
Stage 3: Events were held in African and Caribbean faith and non-faith based community settings; following an educational session people were invited to consent to the study and demographic and medical details, blood pressure, body mass index and urinary albumin creatinine ratio (uACR), (measured by smart-phone analysis) were collected. Culturally tailored information and peer support were available throughout and after testing.
Stage 4: All participants individually followed up by phone and supported to seek medical attention where appropriate.
Stage 5: Quantitative analysis of uACR results.

Results

We have trained 30 PEs, who have performed 305 uACR semi quantitive tests in community settings to date. The majority of participants were black African or black Caribbean (n= 228, 75%; n = 29, 10% respectively), female (n = 163, 53%) and had no known medical history (n=128, 49%). 164 (54%) tests were ACR >3mg/mmol and 24 (8%) >30mg/mmol.

Conclusion

People from African and Caribbean communities appear to be willing to participate in PE led community CKD screening, and high rates of albuminuria are detected. Further qualitative and longitudinal work is underway to assess acceptability and to confirm CKD diagnosis. This approach may provide a new opportunity to reduce health inequalities.