Development of minimal resource pre-screening tools for chronic kidney disease in people with type 2 diabetes

Abstract

Regular chronic kidney disease (CKD) screening can facilitate earlier diagnosis of CKD and preventative action to reduce the risk of CKD progression. People with type 2 diabetes are at a higher risk of developing CKD; hence, it is recommended that they undergo annual screening. However, resources may be limited, particularly in lower-to-middle income countries, and those at the highest risk of having an abnormal CKD screening result should be prioritised for screening. We have developed models to determine which patients are at a high risk of renal impairment. We have shown that, for people with type 2 diabetes and no previous diagnosis of CKD stage 3-5, it is possible to use age, gender, body mass index, duration of type 2 diabetes and blood pressure information to detect those at a higher risk of a reduced glomerular filtration rate. When blood measurements are available, triglyceride and cholesterol measurements can be used to improve the estimate of the risk. Even though risk factors were associated with an increased urine albumin:creatinine ratio, we found no clinical benefit of using the model over a screen-all approach.

Results from a cross-specialty consensus on optimal management of patients with chronic kidney disease (CKD): from screening to complications

“…A minimal-resource prescreening tool has been developed and globally validated for CKD in people with T2DM. This demonstrates that age, gender, body mass index, duration of diabetes and blood pressure information can be used to identify those at an increased risk of CKD 27. This model does not require sophisticated diagnostics and can be used to guide cost-effective screening for CKD where resources are limited.…”