Kidney Week

Abstract: PUB246

Hepatitis B and C Screening in Patients with CKD at the Renal Clinic of SUNY Downstate University Hospital

Session Information

• Publication Only

Category: CKD (Non-Dialysis)

• 2201 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Akatibo, Emmanuel, SUNY Downstate Health Sciences University College of Medicine, New York, New York, United States

Emmanuel Akatibo, MBChB

• Mengal, Fida, SUNY Downstate Health Sciences University College of Medicine, New York, New York, United States

Fida Mengal, MD, MBBS

• Safi, Adnan, SUNY Downstate Health Sciences University College of Medicine, New York, New York, United States

Adnan Safi, MBBS

• Kouyate, Gnama, SUNY Downstate Health Sciences University College of Medicine, New York, New York, United States

Gnama Kouyate, MD

• Nenwani, Hari Vishal, SUNY Downstate Health Sciences University College of Medicine, New York, New York, United States

Hari Vishal Nenwani, MBBS

• Syed, Jahanghir, SUNY Downstate Health Sciences University College of Medicine, New York, New York, United States

Jahanghir Syed, MD

• Gruessner, Angelika C., SUNY Downstate Health Sciences University College of Medicine, New York, New York, United States

Angelika C. Gruessner, PhD

• Chittalae, Seema, SUNY Downstate Health Sciences University College of Medicine, New York, New York, United States

Seema Chittalae, MBBS

• Salifu, Moro O., SUNY Downstate Health Sciences University College of Medicine, New York, New York, United States

Moro O. Salifu, MD, MBA, MPH

• Saggi, Subodh J., SUNY Downstate Health Sciences University College of Medicine, New York, New York, United States

Subodh J. Saggi, MD, MPH

Background

Patients with chronic kidney disease (CKD) are at increased risk for hepatitis B virus (HBV) and hepatitis C virus (HCV) infection due to impaired immunity and frequent healthcare exposure. Guidelines recommend routine screening and HBV immunization; however, adherence in outpatient CKD populations remains inconsistent. Screening practices were largely provider-driven and concentrated in advanced CKD stages, consistent with dialysis preparation workflows. Earlier-stage CKD patients were less consistently screened, reflecting gaps in standardized protocols and preventive care integration.

Methods

We conducted a quality improvement (QI) project evaluating HBV/HCV screening and HBV immunity among adults with CKD stages 1–5 seen in the SUNY Downstate renal clinic from January to December 2024. The primary outcome was completion of the recommended screening panel (HBsAg, HBsAb, HBcAb-total, and HCV antibody). Secondary outcomes included partial screening rates and HBV immune status (HBsAb ≥ 10 mIU/mL). Proposed interventions included: (1) integration of HBV/HCV screening into routine CKD laboratory panels, (2) electronic medical record alerts for CKD stages 2–5 to prompt screening and flag non-immune patients for vaccination, and (3) semiannual audit-and-feedback cycles to improve provider adherence.

Results

Among eligible patients, 23.6% completed the full screening panel, 11.1% had partial testing, and 56.7% had no documented HBV/HCV screening. Screening rates were highest in CKD stage 5, reflecting pre-dialysis protocol adherence, but were substantially lower in stages 1–4. Overall, 54% of patients lacked protective HBV immunity (HBsAb < 10 mIU/mL), with the highest prevalence in stage 5 CKD (60%).

Conclusion

Significant gaps exist in HBV/HCV screening and HBV immunity among CKD patients, particularly in earlier stages. Transitioning from stage-dependent, provider-driven practices to a standardized, system-based approach may improve screening uptake, vaccination rates, and infection prevention.