Kidney specialists and public health officials agree, at-risk populations often go untested for chronic kidney disease (CKD) because patients with early CKD have few or no symptoms to indicate kidney damage. Diagnosis at the earliest stage offers the best patient outcomes.
Abhi Kshirsagar, MD, MPH, professor of medicine and director of the UNC Kidney Center’s Kidney Education and Outreach Program (KEOP) says identifying patients with chronic kidney disease should be relatively simple based on the availability of serum creatinine measurements. However, CKD diagnosis requires both a doctor’s visit and a blood draw, and either step can be a barrier when access to care is limited.
“Several years ago, the UNC Kidney Center developed a self-administered screening tool to help identify individuals with kidney disease without the need for blood draw,” said Kshirsagar, who is the Marion Stedman Covington Distinguished Professor of Medicine. “The tool was a simple checklist (questionnaire) that used knowledge of medical conditions and demographic factors to assign a person his/her probability of having kidney disease.
Early this year, the Centers for Disease Control and Prevention made KEOP’s tool an integral part of its CKD Surveillance System.
“We were excited to learn the CDC had integrated our screening tool to help lay persons assess their risk for kidney disease,” said Heejung Bang, PhD, professor of biostatistics in public health sciences at the University of California at Davis, who worked with the KEOP team to develop the tool. “It can help busy clinicians quickly and accurately identify patients with a high likelihood of chronic kidney disease.”
Developed with the National Health and Nutrition Examinations Surveys (NHANES) and independently validated with a large community cohort study, Atherosclerosis Risk in Communities (ARIC), the tool was the first of its kind to offer a calculator for the probability of CKD. Nine common demographic and medical variables, altogether, were determined to reliably predict CKD. Other researchers nationally and internationally have also independently validated and adapted the tool in a variety of populations.
“Being able to identify CKD in a quicker way allows us to initiate earlier treatment as needed, with the ultimate goal of delaying or even preventing dialysis or kidney transplantation,” Kshirsagar said.
Collaborators included Ron Falk, MD, Romulo Colindres, MD, MSPH, Suma Vupputuri, PhD, MPH, and David Shoham, PhD, MSPH.