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Chronic Kidney Disease (CKD) poses a significant global public health burden, impacting an estimated 800 million individuals worldwide. The increasing prevalence of non-communicable chronic diseases, including diabetes mellitus, hypertension, and obesity, further complicates this problem. In response to this escalating challenge, the Nephrology Society of Rio de Janeiro initiated a targeted screening initiative aligned with World Kidney Day 2023, under the theme 'Caring for the Vulnerable and Preparing for Unforeseen Circumstances".
We carried out a cross-sectional study involving 202 participants recruited from two distinct socioeconomic regions in Rio de Janeiro, Brazil. Risk stratification for CKD was achieved through the Screening for Occult Renal Disease (SCORED) questionnaire, a nine questions test with different weights, that predicts a 20% chance for CKD if an individual score > 4 points. Patients with SCORED > 4 were selected for serum creatinine levels measurement, which was assessed on-site using point-of-care technology (StatSensor Creatinine Connectivity Meter, Nova Biomedical Co., USA). The estimated glomerular filtration rate (eGFR) was computed utilizing the CKD-EPI 2021 equation.
Out of 202 screened individuals, 112 were subjected to creatinine testing guided by their SCORED results. The average age of participants was 62.1 years, with females constituting 61.6% of the sample. The ethnic distribution was predominantly white (58.9%), followed by black (20.5%) and pardo (19.6%). The most frequent comorbidity was hypertension (61.5%), followed by anemia and peripheral circulatory disease (each at 28.1%), and diabetes mellitus (21.9%). The mean serum creatinine level was 1.06 mg/dL (±0.28), and the mean eGFR was 71.03 mL/min (±19.41). The overall prevalence of CKD (eGFR < 60 mL/min) was 28.6%, significantly elevated in the older age groups (p<0.01). Intriguingly, none were previously aware of their CKD status. Upon stratification, we observed that patients with CKD frequently had SCORED values above 8 (CKD: 62.5% vs. non-CKD: 37.5%, p<0.05).
The study highlights the substantial prevalence of undiagnosed CKD, especially among older individuals, confirming the utility of SCORED-based risk stratification and on-site, point-of-care creatinine measurement. Importantly, we found no notable disparities in CKD prevalence across socioeconomic or ethnic lines, reinforcing the efficacy of the SCORED questionnaire as a tool for mass screening.