Screening Is Part of Kidney Disease Education

The National Kidney Disease Education Program (NKDEP), an initiative of the National Institutes of Health, works to reduce the morbidity and mortality caused by chronic kidney disease (CKD) and its complications through educational efforts targeted toward at-risk communities, patients, and health care professionals. Specifically, NKDEP aims to improve early detection of CKD, facilitate identification of patients who are at greatest risk for progression to kidney failure, and promote evidence-based interventions to slow progression of kidney disease. Guided by the Healthy People 2010 (1) objectives for CKD, NKDEP, based in the National Institute of Diabetes and Digestive and Kidney Diseases, works collaboratively with partners throughout the National Institutes of Health, other federal agencies, and voluntary organizations to develop educational messages and deliver them to communities at risk, patients, and health care providers.Effective communication to the public, patients, and health care professionals is critical to achieving the public health mission of NKDEP. NKDEP emphasizes that screening to identify people with CKD as early as possible in the course of their disease is important because effective interventions that can arrest or retard progression exist; however, several factors mitigate against early screening. Most individuals are asymptomatic until late in the course of their disease. A disproportionate burden of CKD is borne by people with decreased access to and decreased trust in the health care system. Use of the screening tests—creatinine-based calculation of estimated GFR (eGFR) and urine albumin/creatinine ratio (UACR), which provide estimates of GFR and daily albumin excretion, respectively—has been hampered by lack of standardization in measurement and reporting (2,3). Health care providers may lack understanding of CKD, screening methods, and the benefits of early intervention. Clinicians may not understand the tests, may not feel confident in explaining results to patients, and may not know which diagnostic (4) and therapeutic …