Chronic kidney disease awareness, screening and prevention: rationale for the design of a public education program.

Design principles for a chronic kidney disease (CKD) screening program start with the general population at increased risk of CKD. Simple risk factor analysis demonstrates diabetes, hypertension, cardiovascular disease and older age as significant associated conditions. More comprehensive risk factor analysis shows only diabetes and hypertension as risk factors in people aged less than 50-60 years, and that anyone aged older than 50-60 years is at risk. Assessment of the relationship between CKD stage and cardiovascular risk factors shows early stage CKD to be associated with poor blood pressure control, which should be addressed. Other risk factors should be more completely assessed to determine if participants and their physicians are adequately addressing factors amenable to treatment to reduce high adverse event rates, premature death and progression to end-stage renal disease (ESRD). Such assessment is needed to reduce the high burden of ESRD on national health-care systems, which can only be addressed by early screening and active treatment.