High risk of renal failure in stage 3B chronic kidney disease is under-recognized in standard medical screening

Area of Science:

• Nephrology
• Public Health
• Medical Screening

Background:

• Assessing the risk of renal failure in individuals with undetected chronic kidney disease (CKD) within standard health screening programs.
• Investigating the prevalence and implications of under-recognized CKD in a self-pay medical screening context.

Purpose of the Study:

• To determine the risk of developing renal failure in patients with under-recognized CKD.
• To evaluate the effectiveness of standard medical screening in identifying CKD and associated risks.

Main Methods:

• Calculating estimated glomerular filtration rate (eGFR) using the abbreviated Modification of Diet in Renal Disease equation.
• Defining under-recognized CKD as eGFR < 60 mL/min/1.73m² with normal routine assessments (serum creatinine, BUN, urinalysis, kidney ultrasound).
• Tracking episodes of renal failure requiring dialysis within two years for CKD stages 3-5.

Main Results:

• 15,817 subjects were recruited; 28.4% had kidney issues identified by routine assessments.
• Prevalence of CKD stages 3A, 3B, 4, and 5 were 8.3%, 1.9%, 0.3%, and 0.2%, respectively.
• 48.7% of stage 3 CKD patients had normal routine assessments; under-recognized stage 3B CKD showed a 20% risk of renal failure.

Conclusions:

• The eGFR equation is superior to routine clinical assessments for identifying subjects with CKD stage 3, particularly stage 3B.
• Early detection of CKD stage 3 using eGFR is crucial for identifying renal failure risk in health management institutions.
• This approach enhances risk stratification for renal failure in asymptomatic individuals undergoing health screenings.