Observational studyJornal brasileiro de nefrologia
Screening for CKD in undiagnosed populations with diabetes and hypertension: lessons from the SEARCH study.
Observational study in Jornal brasileiro de nefrologia. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Chronic kidney disease in high-risk populations: the urgent need to close the diagnostic gap through systematic screening.Jornal brasileiro de nefrologiaArticle
- Brazil between guidelines and reality: the challenges of chronic kidney disease care in Brazil.Jornal brasileiro de nefrologiaArticle
- Albuminuria as the foundation for modern nephroprotective therapy.Jornal brasileiro de nefrologiaArticle
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDespite advances in chronic kidney disease (CKD) management, early diagnosis and risk stratification remain major challenges. This study analyzed national data derived from a Brazilian CKD screening campaign, targeting high-risk individuals unaware of their condition, to estimate CKD prevalence and evaluate longitudinal trends in estimated glomerular filtration rate (eGFR).
methodsThis cross-sectional, observational study evaluated adults with diabetes mellitus (DM) and/or arterial hypertension, previously undiagnosed with CKD, who participated in a CKD screening campaign. Demographic, clinical, and laboratory data-including serum creatinine and albumin-to-creatinine ratio (ACR)-were collected. CKD staging followed Kidney Disease: Improving Global Outcomes (KDIGO) criteria, and eGFR was calculated using the CKD-EPI 2021 equation. Mixed effect models were used to assess eGFR trajectories and logistic regression was used to examine CKD risk factors.
resultsAmong 14,239 high-risk participants (mean age 54 years; 84% hypertensive; 37% diabetic), CKD was newly identified in 19.6%, with 11.3% showing eGFR <60 mL/min and 11.1% ACR >30 mg/g. Despite abnormal ACR results, testing remained uncommon: <5% prior to the campaign and <7% afterward. eGFR decline was steeper among diabetics (+40%), hypertensive individuals (+17%), those >65 years of age (+17%), and individuals with body mass index (BMI) >25 kg/m2 (+60%). Logistic regression models of risk projected ~169,000 kidney failure cases in 2 years and ~500,000 in 5 years, excluding competing mortality risk.
conclusionA high prevalence of previously undiagnosed CKD was found in this high-risk population. Despite universal access to testing in Brazil, albuminuria remains markedly underused, representing a missed opportunity for early detection and implementation of nephroprotective interventions.
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