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Leveraging the South African Diabetes Prevention Programme to screen for chronic kidney disease: an observational study

OBJECTIVE: To evaluate the viability of leveraging an existing screening programme (the South African Diabetes Prevention Programme (SA-DPP)) to screen for chronic kidney disease (CKD), by assessing the yield of CKD cases among those participating in the programme. DESIGN: Observational study conduc...

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Autores principales: George, Cindy, Hill, Jillian, Nqebelele, Unati, Peer, Nasheeta, Kengne, Andre P
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9827250/
https://www.ncbi.nlm.nih.gov/pubmed/36609330
http://dx.doi.org/10.1136/bmjopen-2022-068672
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author George, Cindy
Hill, Jillian
Nqebelele, Unati
Peer, Nasheeta
Kengne, Andre P
author_facet George, Cindy
Hill, Jillian
Nqebelele, Unati
Peer, Nasheeta
Kengne, Andre P
author_sort George, Cindy
collection PubMed
description OBJECTIVE: To evaluate the viability of leveraging an existing screening programme (the South African Diabetes Prevention Programme (SA-DPP)) to screen for chronic kidney disease (CKD), by assessing the yield of CKD cases among those participating in the programme. DESIGN: Observational study conducted between 2017 and 2019. SETTING: 16 resource–poor communities in Cape Town, South Africa. PARTICIPANTS: 690 participants, aged between 25 and 65 years, identified as at high risk for type 2 diabetes mellitus (T2DM) by the African Diabetes Risk Score. PRIMARY OUTCOME MEASURE: The prevalence of CKD among those participating in the SA-DPP. RESULTS: Of the 2173 individuals screened in the community, 690 participants underwent further testing. Of these participants, 9.6% (n=66) and 18.1% (n=125) had screen-detected T2DM and CKD (defined as an estimated glomerular filtration rate (eGFR) of<60 mL/min/1.73 m(2) and/or albumin-to-creatinine ratio >3 mg/mmol), respectively. Of those with CKD, 73.6% (n=92), 17.6% (n=22) and 8.8% (n=11) presented with stages 1, 2 and 3, respectively. Of the participants with an eGFR <60 mL/min/1.73 m(2), 36.4% had no albuminuria and of those with normal kidney function (eGFR ≥90 mL/min/1.73 m(2)), 10.2% and 3.8% had albuminuria stages 2 and 3, respectively. Of those with T2DM and hypertension, 22.7% and 19.8% had CKD, respectively. CONCLUSION: The fact that almost one in five participants identified as high risk for T2DM had CKD underscores the value of including markers of kidney function in an existing screening programme. By using an opportunistic approach to screen high-risk individuals, those with CKD can be identified and appropriately treated to reduce disease progression.
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spelling pubmed-98272502023-01-10 Leveraging the South African Diabetes Prevention Programme to screen for chronic kidney disease: an observational study George, Cindy Hill, Jillian Nqebelele, Unati Peer, Nasheeta Kengne, Andre P BMJ Open Epidemiology OBJECTIVE: To evaluate the viability of leveraging an existing screening programme (the South African Diabetes Prevention Programme (SA-DPP)) to screen for chronic kidney disease (CKD), by assessing the yield of CKD cases among those participating in the programme. DESIGN: Observational study conducted between 2017 and 2019. SETTING: 16 resource–poor communities in Cape Town, South Africa. PARTICIPANTS: 690 participants, aged between 25 and 65 years, identified as at high risk for type 2 diabetes mellitus (T2DM) by the African Diabetes Risk Score. PRIMARY OUTCOME MEASURE: The prevalence of CKD among those participating in the SA-DPP. RESULTS: Of the 2173 individuals screened in the community, 690 participants underwent further testing. Of these participants, 9.6% (n=66) and 18.1% (n=125) had screen-detected T2DM and CKD (defined as an estimated glomerular filtration rate (eGFR) of<60 mL/min/1.73 m(2) and/or albumin-to-creatinine ratio >3 mg/mmol), respectively. Of those with CKD, 73.6% (n=92), 17.6% (n=22) and 8.8% (n=11) presented with stages 1, 2 and 3, respectively. Of the participants with an eGFR <60 mL/min/1.73 m(2), 36.4% had no albuminuria and of those with normal kidney function (eGFR ≥90 mL/min/1.73 m(2)), 10.2% and 3.8% had albuminuria stages 2 and 3, respectively. Of those with T2DM and hypertension, 22.7% and 19.8% had CKD, respectively. CONCLUSION: The fact that almost one in five participants identified as high risk for T2DM had CKD underscores the value of including markers of kidney function in an existing screening programme. By using an opportunistic approach to screen high-risk individuals, those with CKD can be identified and appropriately treated to reduce disease progression. BMJ Publishing Group 2023-01-06 /pmc/articles/PMC9827250/ /pubmed/36609330 http://dx.doi.org/10.1136/bmjopen-2022-068672 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Epidemiology
George, Cindy
Hill, Jillian
Nqebelele, Unati
Peer, Nasheeta
Kengne, Andre P
Leveraging the South African Diabetes Prevention Programme to screen for chronic kidney disease: an observational study
title Leveraging the South African Diabetes Prevention Programme to screen for chronic kidney disease: an observational study
title_full Leveraging the South African Diabetes Prevention Programme to screen for chronic kidney disease: an observational study
title_fullStr Leveraging the South African Diabetes Prevention Programme to screen for chronic kidney disease: an observational study
title_full_unstemmed Leveraging the South African Diabetes Prevention Programme to screen for chronic kidney disease: an observational study
title_short Leveraging the South African Diabetes Prevention Programme to screen for chronic kidney disease: an observational study
title_sort leveraging the south african diabetes prevention programme to screen for chronic kidney disease: an observational study
topic Epidemiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9827250/
https://www.ncbi.nlm.nih.gov/pubmed/36609330
http://dx.doi.org/10.1136/bmjopen-2022-068672
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