Screening people of low socioeconomic status for chronic kidney disease (CKD) may prove more valuable than screening seniors, according to Dutch researchers. The study found that people of low socioeconomic status are at higher risk of CKD and its complications, including kidney decline and cardiovascular events, compared to adults older than age 60.
For the study, the investigators compared 3 screening approaches in 3,411 individuals:
Traditional screening with the addition of seniors
Traditional screening with the addition of people of low socioeconomic status (i.e., only a primary school education)
Participants underwent 4 rounds of screening over more than 9 years. The numbers of individuals needed to screen to detect one CKD case were 5.6 in Approach 1 and 6.5 each in Approach 2 and 3.
In Approach 2 (seniors), the odds of cardiovascular events were 87 to 92% higher among persons with CKD compared to those without the disease. The odds were more striking in Approach 3 (low income individuals), however: 128 to 231%.
The rate of renal function decline was also faster among low-income individuals than among seniors.
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Background and objective Three screening approaches were compared for their ability to detect CKD cases, and identify patients with CKD who have a higher rate of incident cardiovascular disease (CVD) events and renal function decline. Approach 1 was the traditional CKD screening approach, targeting only individuals with known diabetes, hypertension, or CVD history. Approach 2 was defined as Approach 1+elderly, and Approach 3 as Approach 1+low–socioeconomic status (SES) individuals.
Design, setting, participants, & measurements Data on 3411 individuals from the general population in The Netherlands were examined.