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Related Experiment Videos

Screening for chronic kidney disease: unresolved issues.

William M McClellan1, Sylvia P B Ramirez, Claudine Jurkovitz

  • 1Georgia Medical Care Foundation, Atlanta, USA. bmcclellan@gmcf.org

Journal of the American Society of Nephrology : JASN
|June 24, 2003
PubMed
Summary

Screening for chronic kidney disease (CKD) is recommended for at-risk individuals to control the epidemic of end-stage renal disease. Effective CKD screening requires proven benefits, available tests, and robust follow-up care.

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Area of Science:

  • Nephrology
  • Public Health
  • Epidemiology

Background:

  • End-stage renal disease (ESRD) represents a significant public health epidemic in the United States.
  • Routine screening for undetected kidney disease in at-risk populations is recommended for CKD control and prevention.

Purpose of the Study:

  • To outline the essential criteria for evaluating the adoption of screening strategies for chronic kidney disease (CKD).
  • To ensure that proposed CKD screening programs are justifiable from a public health perspective.

Main Methods:

  • Evaluation of generally accepted criteria for screening recommendations.
  • Assessment of disease characteristics, including natural history and asymptomatic periods.
  • Consideration of early treatment benefits and availability of screening tests.

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  • Examination of health system capacity for follow-up care.
  • Emphasis on the need for cost-effectiveness and randomized trial evidence.

    • Main Results:

    • CKD screening is viable if the disease is a major public health issue with a detectable asymptomatic phase.
    • Early treatment must demonstrably improve outcomes for screening to be effective.
    • Acceptable diagnostic tests, adequate follow-up care, and proven cost-effectiveness are prerequisites for widespread implementation.

    Conclusions:

    • Implementing CKD screening requires a comprehensive approach, addressing disease burden, diagnostic capabilities, treatment efficacy, and healthcare infrastructure.
    • Evidence from randomized trials is crucial to validate the effectiveness of screening in reducing CKD prevalence and improving patient outcomes.