Original investigation: pathogenesis and treatment of kidney disease and hypertensionEarly detection of kidney disease in community settings: the kidney early evaluation program (KEEP)
Section snippets
Participant recruitment
National Kidney Foundation (NKF) affiliates conducted 135 KEEP screening programs in 33 states. Screenings were advertised through local media (radio and television stations, newspapers), announcements by clergy from the pulpit, flyers, posters, and information provided to dialysis patients, with an emphasis on minority communities. Screening sites included churches, hospitals, health centers, schools, community centers, and dialysis units. Eligibility criteria for screening were age of 18
Sociodemographic characteristics of participants
Of 6,851 individuals who attended the screening programs, 6,071 people were eligible for inclusion in this analysis based on inclusion criteria (Fig 1). Demographic and lifestyle data are listed in Table 1. Participants screened during the first 17 months of the KEEP program were predominately African American, women, middle aged (mean age, 52 ± 15.6 [SD] years; range, 18 to 101 years), well educated, with some form of health insurance, and with access to health care providers.
Discussion
The worldwide epidemic of ESRD has led to concerns about the burden of mild to moderate CKD in the general population.2, 30 Mild CKD appears to be very common, as recently reported in the NKF K/DOQI guidelines.2, 4, 30 The adverse outcomes of CKD can be prevented or delayed through early detection and early intervention strategies. The KEEP 2.0 program shows the effectiveness of community-based targeted health screening programs in identifying large numbers of individuals at high risk for
References (50)
- et al.
Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitusA randomized, prospective 6-year study
Diabetes Res Clin Pract
(1995) Role of dietary protein and blood pressure in the progression of renal disease
Kidney Int
(1996)- et al.
Effect of lipid reduction on the progression of renal diseaseA meta-analysis
Kidney Int
(2001) Phosphate excess and progressive renal failureThe precipitation-calcification hypothesis
Kidney Int
(1989)- et al.
Proteinuria and cardiovascular disease
Am J Kidney Dis
(2001) - et al.
Smoking as a risk factor for end-stage renal failure in men with primary renal disease
Kidney Int
(1998) Diabetic nephropathyPrevention and treatment
Kidney Int
(2001)- et al.
RenoprotectionOne or many therapies?
Kidney Int
(2001) - et al.
Identification of persons at high risk for kidney disease via targeted screeningThe NKF Kidney Early Evaluation Program
Kidney Int Suppl
(2003) - et al.
Prevalence of urinary tract infections and renal scars in patients with diabetes mellitus
Diabetes Res Clin Pract
(2001)
Cigarette smoking is associated with augmented progression of renal insufficiency in severe essential hypertension
Am J Kidney Dis
Cigarette smoking predicts faster progression of type 2 established diabetic nephropathy despite ACE inhibition
Am J Kidney Dis
Albuminuria and renal insufficiency prevalence guides population screeningResults from the NHANES III
Kidney Int
DeathsPreliminary data for 2000
Natl Vital Stat Rep
The national epidemic of chronic kidney diseaseWhat we know and what we can do
Postgrad Med
USRDS 2001 Annual Data Report
Prevalence of high blood pressure and elevated serum creatinine level in the United States
Arch Intern Med
Serum creatinine levels in the United StatesThe Third National Health and Nutrition Examination Survey (NHANES III)
Am J Kidney Dis
Familial aggregation of renal disease in a population-based case-control study
J Am Soc Nephrol
The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus
N Engl J Med
UK Prospective Diabetes Study 33Intensive blood glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes
Lancet
Effect of antihypertensive treatment on kidney function in diabetic nephropathy
Br Med J
Beneficial effects of angiotensin converting enzyme inhibition on renal function in patients with diabetic nephropathy
Br Med J
ACE inhibitors to prevent end-stage renal disease:When to start and why possibly never to stop: A post hoc analysis of the REIN trial results
J Am Soc Nephrol
Long-term antihypertensive treatment inhibiting progression of diabetic nephropathy
Br Med J
Cited by (210)
Overcoming Barriers to Implementing New Therapies for Diabetic Kidney Disease: Lessons Learned
2021, Advances in Chronic Kidney DiseaseNeighborhood Socioeconomic Status and Identification of Patients With CKD Using Electronic Health Records
2021, American Journal of Kidney DiseasesCitation Excerpt :Several studies have assessed the effectiveness of targeted screening interventions for CKD. The See Kidney Disease (SeeKD) screening program in Canada and the National Kidney Foundation’s Kidney Early Evaluation Program (KEEP) in the United States targeted at-risk individuals for CKD (hypertension, DM, high-risk ethnic group [SeeKD], and first-order relative with hypertension or CKD [KEEP]).31,32 Prevalence of eGFR <60 mL/min/1.73 m2 in the screened population ranged between 16% and 19%.
Epidemiology research to foster improvement in chronic kidney disease care
2020, Kidney InternationalCitation Excerpt :For example, targeted screening programs such as the Kidney Early Evaluation Program and the Screening and Early Evaluation of Kidney Disease Project have been developed and implemented worldwide to increase health awareness.39–43 Epidemiology methods, including surveys and cross-sectional and longitudinal analyses, provided evidence for their diagnostic utility, suggesting that participation in these programs was associated with higher rates of physician follow-up, better ESKD preparation, and survival.40–47 Other programs have been implemented to expand health care access among people with low income (e.g., Affordable Care Act expanding Medicaid coverage), address homelessness (the Ottawa Inner City Health Project), improve low literacy and numeracy, and bolster social support in high-risk populations.48–50
The Association of Altitude and the Prevalence of Anemia Among People With CKD
2019, American Journal of Kidney DiseasesPreliminary analysis of the effect of Stevia (Stevia rebaudiana) in patients with chronic kidney disease (stage I to stage III)
2018, Contemporary Clinical Trials CommunicationsMild Albuminuria Is a Risk Factor for Faster GFR Decline in the Nondiabetic Population
2018, Kidney International Reports
The Kidney Early Evaluation Program (KEEP) is a program of the National Kidney Foundation, Inc. KEEP was supported by Ortho Biotech Products, LP, with additional support from Bayer Diagnostics; Satellite Laboratory Services of Redwood City, CA; Satellite Healthcare; and Ocean Spray.