Screening for Chronic Kidney Disease (CKD): A Systematic Review and Meta-Analysis of Trials and Quasi Experimental Studies
Author(s)
Nur Aziemah Ibrahim, MBBS, MPH1, Joshua Rothwell, None2, Ka Keat Lim, MPharm, MSc, PhD3.
1King's College London, London, United Kingdom, 2Department of Radiology, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom, 3Lecturer in Health Economics, Queen Mary University of London, London, United Kingdom.
1King's College London, London, United Kingdom, 2Department of Radiology, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom, 3Lecturer in Health Economics, Queen Mary University of London, London, United Kingdom.
OBJECTIVES: Chronic kidney disease (CKD) can progress to end-stage renal failure. Early detection may slow down CKD progression the advanced stages and reduce downstream complications. This study aims to evaluate the efficacy of early screening for CKD in detecting undiagnosed CKD in asymptomatic individuals, based on published literature.
METHODS: We systematically searched Cochrane Library, Ovid Medline, Embase, Web of Science , ClinicalTrials.gov and ICTRP for studies published between Jan 2011 and June 2024. Two reviewers independently screened the abstracts and full text. We included randomised trials (RCT) and quasi-experimental studies comparing CKD screening against no screening among adults >=18 years old. We extracted CKD detection rate of all trial arms, and the screening uptake rate of the screening arms. We meta-analysed the CKD detection rate and screening uptake rate, using random-effects model.
RESULTS: From 3260 screened references, we found three RCTs (US or UK) enrolling 366,823 (47% men) individuals aged 40-80 years, and one RCT protocol (Australia). The trials had 1-4 screening arms. Compared to no screening, screening increased CKD detection by 50% (RR 1.50; 95%CI 1.36-1.65). In subgroup analyses, detection was lower and uncertain for follow-up <1 year (RR 1.27; 95%CI 0.02-104.20), which increased for follow-ups 1-2 years (RR 1.50; 95%CI 1.45-1.54) and >2 years (RR 1.50; 95%CI 1.50-1.51). Screening detection was similar between those <60 (RR1.50; 95%CI 1.37-1.65) vs >=60 years old (RR 1.47; 95%CI 1.45-1.49). Meta-analyses for screening uptake, and risk-of-bias ratings for the included studies are ongoing and is expected to be completed before the conference date.
CONCLUSIONS: CKD screening may increase CKD detection among healthy individuals, with similar detection rates among those <60 and >=60 years old. However, the effect may only be significant if the individuals are followed up over at least a year.
METHODS: We systematically searched Cochrane Library, Ovid Medline, Embase, Web of Science , ClinicalTrials.gov and ICTRP for studies published between Jan 2011 and June 2024. Two reviewers independently screened the abstracts and full text. We included randomised trials (RCT) and quasi-experimental studies comparing CKD screening against no screening among adults >=18 years old. We extracted CKD detection rate of all trial arms, and the screening uptake rate of the screening arms. We meta-analysed the CKD detection rate and screening uptake rate, using random-effects model.
RESULTS: From 3260 screened references, we found three RCTs (US or UK) enrolling 366,823 (47% men) individuals aged 40-80 years, and one RCT protocol (Australia). The trials had 1-4 screening arms. Compared to no screening, screening increased CKD detection by 50% (RR 1.50; 95%CI 1.36-1.65). In subgroup analyses, detection was lower and uncertain for follow-up <1 year (RR 1.27; 95%CI 0.02-104.20), which increased for follow-ups 1-2 years (RR 1.50; 95%CI 1.45-1.54) and >2 years (RR 1.50; 95%CI 1.50-1.51). Screening detection was similar between those <60 (RR1.50; 95%CI 1.37-1.65) vs >=60 years old (RR 1.47; 95%CI 1.45-1.49). Meta-analyses for screening uptake, and risk-of-bias ratings for the included studies are ongoing and is expected to be completed before the conference date.
CONCLUSIONS: CKD screening may increase CKD detection among healthy individuals, with similar detection rates among those <60 and >=60 years old. However, the effect may only be significant if the individuals are followed up over at least a year.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH209
Topic
Epidemiology & Public Health, Health Service Delivery & Process of Care, Study Approaches
Topic Subcategory
Public Health
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Urinary/Kidney Disorders