Key result
Minimal resource pre-screening offers no benefit over a screen-all approach for albuminuria in T2D.
Why the study?
People with type 2 diabetes are at higher risk of CKD and require annual screening, but limited resources necessitate prioritizing those at highest risk for abnormal CKD results.
Do minimal resource pre-screening tools accurately identify reduced glomerular filtration rate in people with type 2 diabetes compared to a screen-all approach?
Observational
Do minimal resource pre-screening tools accurately identify reduced glomerular filtration rate in people with type 2 diabetes compared to a screen-all approach?
A minimal-resource pre-screening model using basic clinical parameters can identify type 2 diabetes patients at high risk for reduced GFR, though it does not outperform universal screening for albuminuria.
Models may prioritize CKD screening in type 2 diabetes with limited resources; leaves open external validation before practice adoption.
Regular chronic kidney disease (CKD) screening can facilitate earlier diagnosis of CKD and preventative action to reduce the risk of CKD progression. People with type 2 diabetes are at a higher risk of developing CKD; hence, it is recommended that they undergo annual screening. However, resources may be limited, particularly in lower-to-middle income countries, and those at the highest risk of having an abnormal CKD screening result should be prioritised for screening. We have developed models to determine which patients are at a high risk of renal impairment. We have shown that, for people with type 2 diabetes and no previous diagnosis of CKD stage 3-5, it is possible to use age, gender, body mass index, duration of type 2 diabetes and blood pressure information to detect those at a higher risk of a reduced glomerular filtration rate. When blood measurements are available, triglyceride and cholesterol measurements can be used to improve the estimate of the risk. Even though risk factors were associated with an increased urine albumin:creatinine ratio, we found no clinical benefit of using the model over a screen-all approach.
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Sammut‐Powell et al. (2022) conducted an observational in Chronic kidney disease in type 2 diabetes. Minimal resource pre-screening models vs. Screen-all approach was evaluated on Reduced glomerular filtration rate and increased urine albumin:creatinine ratio. A minimal resource pre-screening model identified type 2 diabetes patients at risk of reduced GFR, but showed no clinical benefit over a screen-all approach for albuminuria.
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