Mathew Timothy H, Corso Olivia, Ludlow Marie, Boyle Adam, Cass Alan, Chadban Steven J, Joyner Beres, Shephard Mark, Usherwood Tim
Kidney Health Australia, Adelaide, South Australia, Australia.
Kidney Int Suppl. 2010 Mar(116):S9-16. doi: 10.1038/ki.2009.538.
The pilot program Kidney Evaluation for You (KEY) was conducted in Australia to screen for chronic kidney disease (CKD). Targeting people at high risk (those with diabetes, hypertension, a first-degree relative with kidney failure, or age >50 years), KEY aimed to establish community-based screening protocols, assess efficacy in promoting changes in risk-factor management, and explore participant CKD awareness. KEY offered free cardiovascular and kidney checks using point-of-care testing for on-site pathology measurements (estimated glomerular filtration rate, hemoglobin A1c, cholesterol, hemoglobin, albuminuria), lifestyle assessment, and exit interviews. Participants were telephoned at 3 months to ascertain whether KEY advice had been followed. Community and health professional support was strong; 99% of participants rated involvement as beneficial. Of 402 high-risk individuals recruited, findings were suggestive of CKD in 20.4%. Of these, 69% had hypertension, 30% diabetes, and 40% elevated total cholesterol. All participants with CKD stage 3b or higher were aged >61 years. Overall, 58% of participants were referred to their primary care providers for further action; of these, 82% saw their doctors in the next 3 months and 94% discussed KEY results. Follow-up telephone contact was successful for 82% of participants. A change in management occurred for 67%. Thus, the KEY approach to early detection of CKD and selected referral of participants was largely successful.
“为您评估肾脏”(KEY)试点项目在澳大利亚开展,旨在筛查慢性肾脏病(CKD)。该项目针对高危人群(患有糖尿病、高血压、有肾衰竭一级亲属或年龄大于50岁者),旨在建立基于社区的筛查方案,评估促进风险因素管理变化方面的效果,并探究参与者对CKD的认知情况。KEY提供免费的心血管和肾脏检查,使用即时检验进行现场病理测量(估算肾小球滤过率、糖化血红蛋白、胆固醇、血红蛋白、蛋白尿)、生活方式评估以及离场访谈。在3个月时对参与者进行电话随访,以确定是否遵循了KEY给出的建议。社区和卫生专业人员的支持力度很大;99%的参与者认为参与该项目有益。在招募的402名高危个体中,20.4%的检查结果提示患有CKD。其中,69%患有高血压,30%患有糖尿病,40%的总胆固醇升高。所有CKD 3b期及以上的参与者年龄均大于61岁。总体而言,58%的参与者被转介给他们的初级保健提供者以采取进一步行动;其中,82%在接下来的3个月内看了医生,94%讨论了KEY的检查结果。82%的参与者通过电话成功进行了随访。67%的参与者的管理方式发生了改变。因此,KEY早期检测CKD并对参与者进行选择性转诊的方法在很大程度上是成功的。