Project title

Free-of-charge CKD screening in at-risk populations

Country

Hong Kong

Background

There is currently no existing study in the publicly-funded medical sector or the private primary care clinic setting on the local prevalence of undetected CKD in an at-risk population. While the HKSAR government encourages the screening of chronic diseases in private primary care clinics, it’s also important to consider the related workload and wellbeing of the private primary care physicians (PCPs) to ensure the success of such a programme.

Summary

Target population

Patients aged over 45 who have one of the following risk factors:

Diabetes, hypertension, hyperlipidemia, obesity (BMI ≥ 23), a family history of CKD, or a medical history of kidney disease.

 

Method

  1. A supporting team consisting of:
    1. The HKCMA Project Manager will prepare all educational material, consent forms, work sheets, and laboratory vouchers for each participating doctor and each patient. They will also ensure there is an adequate supply of urine dipsticks to be used.
    2. A network of laboratories will obtain and analyse each participating patient's urine and blood for the eGFR and urine albumin/creatinine ratio.
  2. The PCP will be responsible for three important steps in this project:
    1. Identifying the at-risk patient (as stated above), recruiting the patient into the study, signing the consent form, and performing the initial bedside screening for urine microalbumin using the urinary dipstick provided by the HKCMA.
    2. Providing a laboratory voucher to microalbuminuria-positive patients for them to undertake blood and urine testing at the designated laboratory.
    3. The laboratory results will be scrutinised by the PCP using the ADA-KDIGO 2022 consensus heat map, and follow-up recommendations will be made by the PCP according to the heat map pathway.
  3. The Project Manager will receive all data from the doctor and carry out pooled data analysis while protecting the identity of the patient.

Outcome

By understanding the prevalence of undetected CKD in the at-risk populations, and in which at-risk subgroups, we will be in a better position to advise the HKSAR Government as to whether routine CKD screening should be undertaken for all at-risk groups in the government-run primary care setting. 

We also hope to raise awareness of CKD among private practitioners and at-risk patients. 

The grant from MPSF will facilitate our acknowledgement of the contribution from our participating PCPs for their extra workload, thus striking a balance between the advancement of public health policy and the wellbeing of participating doctors.