PracticeUpdate Conference Series ISN WCN 2019

Kidney Disease Screening and

Awareness Program Effectively Identifies Undetected Proteinuria The programprovides high-risk population with screening and education.

T he Kidney Disease Screening and Awareness Program (KDSAP) is an effective model to identify the population with a high risk for kidney disease and a low awareness at the com- munity level, according to research presented at WCN 2019. KDSAP is a student-run organization that partners with physicians and community members to pro- vide free kidney screenings and health education to underserved populations. So far, the program has revealed proteinuria rates in high-risk popu- lations that are more than double those seen in previous studies, as well as an alarmingly low rate of awareness among those with the condition. Although chronic kidney disease is a major health issue worldwide, awareness of the disease remains low in the general population, a reality that cre- ates significant challenges for early intervention. Screening for proteinuria and raising awareness of chronic kidney disease are crucial to public health, the research team stated in their abstract. “Currently, there is no effective strategy to improve awareness of proteinuria. [The] Kidney Disease Screening and Awareness Program aims for early detection of [chronic kidney disease] risk factors by providing free community health screening.” The research, presented by Min Zhuo, MD, of the Beth Israel Deaconess Medical Center in Boston, evaluated awareness of proteinuria by asking study participants two questions: ƒ ƒ Have you ever had protein in the urine? ƒ ƒ Do you have kidney disease? Data were collected from October 2011 to May 2018 through KDSAP. The diagnosis of proteinuria was based on a cross-sectional measurement of urine dipstick, and the awareness of proteinuria was defined as participants with trace or more

protein on the urine dipstick who answered “yes” to either of the two questions. In all, 2304 out of 2432 KDSAP participants with available urine analysis results were evaluated. The population was ethnically diverse (54.1% Asian, 18.5% African American, 14.5% Caucasian and 9.7% Hispanic), and 44.2% of participants were non-English speaking. Those participants with proteinuria were younger, more likely to be male, African American, and a smoker. This group was also more likely to have hypertension, diabetes, a family history of kidney disease, a higher body mass index, and microscopic hematuria. The rate of proteinuria among study participants was 20%. This was more than two-fold greater than rates revealed in other studies. “Alarmingly, the awareness of mild proteinuria (trace or 1+) and heavy proteinuria (2+ or above) were only 10% and 39.5%, respectively,” the research team noted in their abstract. “Although the older participants tended to have higher awareness, the overall awareness of proteinuria was low (15.8%).” There were no significant differences in insurance coverage and access to care between the protein- uria and non-proteinuria groups. “Efforts are needed to promote early detection of proteinuria, improve awareness, and modify risk factors to improve outcomes,” concluded the study investigators in their abstract. “We proposed that KDSAP is an effective model to identify the pop- ulation with high risk of kidney disease and low awareness at the community level.”

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WCN 2019 • PRACTICEUPDATE CONFERENCE SERIES 17