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Chronic kidney disease causes substantial global morbidity and increases cardiovascular and all-cause mortality. Unlike other chronic diseases with established strategies for screening, there has been no consensus on whether health systems and governments should prioritize early identification and intervention for CKD. Guidelines on evaluating and managing early CKD are available but have not been universally adopted in the absence of incentives or quality measures for prioritizing CKD care. The burden of CKD falls disproportionately upon persons with lower socioeconomic status, who have a higher prevalence of CKD, limited access to treatment, and poorer outcomes. Therefore, identifying and treating CKD at the earliest stages is an equity imperative. In 2019, Kidney Disease: Improving Global Outcomes (KDIGO) held a controversies conference entitled, Early Identification and Intervention in CKD. Participants identified strategies for screening, risk stratification, and treatment for early CKD and the key health system and economic factors for implementing these processes. A consensus emerged that CKD screening coupled with risk stratification and treatment should be implemented immediately in high-risk persons and that this should ideally occur in primary or community care settings with tailoring to the local context.

Original publication

DOI

10.1016/j.kint.2020.10.012

Type

Journal

Kidney Int

Publication Date

22/10/2020

Keywords

Albuminuria, chronic kidney disease, cost-effectiveness, creatinine, cystatin, detection, glomerular filtration rate, interventions, kidney failure, proteinuria, risk models, risk stratification, screening