Center of Innovation for Complex Chronic Healthcare, Jesse Brown VA Medical Center, Chicago, IL, USA.
Edward Hines Jr. VA Hospital, Hines, IL, USA.
BMC Nephrol. 2018 Oct 25;19(1):295. doi: 10.1186/s12882-018-1079-y.
Early detection and treatment of chronic kidney disease (CKD) and its risk factors improves outcomes; however, many high-risk individuals lack access to healthcare. The National Kidney Foundation of Illinois (NKFI) developed the KidneyMobile (KM) to conduct community-based screenings, provide disease education, and facilitate follow-up appointments for diabetes, hypertension, and CKD.
Cross-sectional design. Adults > = 18 years of age participated in NKFI KM screenings across Illinois between 2005 and 2011. Sociodemographic and medical history were self-reported using structured interviews; laboratory data and blood pressure were assessed using standard procedures.
Among 20,770 participants, mean age was 53.5 years, 68% were female, 49% were African-American or Hispanic, 21% primarily spoke Spanish, and at least 27% lacked health insurance. Seventy-eight percent of participants with elevated blood pressure (≥ 140/90 mmHg) were aware of having hypertension, 93% of participants with abnormal blood glucose (fasting glucose > 126 mg/dl or a random glucose of > 200 mg/dL) were aware of having diabetes, and 19% of participants with albuminuria (> 30 mg/gm) were aware of having CKD. In participants reporting hypertension, 47% had blood pressure ≥ 140/90 mmHg, and in those reporting diabetes, 56% had blood glucose ≥ 130 mg/dl (fasting) or ≥ 180 mg/dl (random). Among 4937 participants with abnormal screening findings that participated in follow-up interviews, 69% reported having further medical evaluation.
A high-risk disadvantaged population is being reached by the NKFI KidneyMobile and connected with healthcare services. A significant proportion of participants were newly informed of having abnormal results suggestive of diabetes, hypertension, and/or CKD or that their diabetes and hypertension were inadequately controlled.
早期发现和治疗慢性肾脏病（CKD）及其危险因素可改善预后；然而，许多高危人群无法获得医疗保健。伊利诺伊州国家肾脏基金会（NKFI）开发了 KidneyMobile（KM），以进行基于社区的筛查，提供疾病教育，并为糖尿病、高血压和 CKD 患者提供后续预约服务。
采用横断面设计。2005 年至 2011 年间，年龄≥18 岁的成年人在伊利诺伊州各地参加了 NKFI KM 筛查。使用结构化访谈报告社会人口统计学和病史；使用标准程序评估实验室数据和血压。
在 20770 名参与者中，平均年龄为 53.5 岁，68%为女性，49%为非裔美国人或西班牙裔，21%主要讲西班牙语，至少 27%的人没有医疗保险。78%的血压升高（≥140/90mmHg）的参与者知道自己患有高血压，93%的血糖异常（空腹血糖>126mg/dl 或随机血糖>200mg/dL）的参与者知道自己患有糖尿病，19%的蛋白尿（>30mg/gm）的参与者知道自己患有 CKD。在报告高血压的参与者中，47%的人血压≥140/90mmHg，在报告糖尿病的参与者中，56%的人空腹血糖≥130mg/dl（空腹）或随机血糖≥180mg/dl。在 4937 名接受异常筛查结果并参加随访访谈的参与者中，69%的人报告进行了进一步的医学评估。
NKFI KidneyMobile 正在接触高危弱势群体，并为他们提供医疗保健服务。相当一部分参与者新得知自己的结果异常，提示患有糖尿病、高血压和/或 CKD，或他们的糖尿病和高血压控制不佳。
