Save kidneys, protect your heart

Chronic kidney disease (CKD) is a grave public health concern, affecting a large section of the worldwide population. Good management of CKDs can slow the progression of renal dysfunction, prevent metabolic complications and reduce cardiovascular ailments. Physician’s awareness of such disease is critical for the implementation of evidence-based therapies and patient awareness is a major determinant of the adherence to those therapies.
In Nepal, individual awareness of CKD and its risk factors remains low. CKD awareness may be particularly important among persons who exhibit
clinical markers, possibly resulting from their renal dysfunction, as they would benefit from a lifestyle change and medical interventions.
The goal of a medical screening programme is to recognise a disease in its preclinical phase so that interventions can be done in earlier stages, leading to better outcomes. Screening programmes can also promote public awareness and education, encourage physician adherence to clinical practice guidelines and serve as medical outreach to underserved populations. Such programmes however, have risks and costs along with benefits. To establish how useful a screening programme is, health care providers need to answer three important questions: “Does early treatment improve prognosis?”; “How valid and reproducible is the screening test?” and “What is the yield of the screening service?”
However, a screening test is not intended to be diagnostic. Persons with positive or suspicious findings must be referred to specialists for diagnosis and necessary treatment.
Widespread screening programmes have led to a decline in the incidence of syphilis and a decrease in mortality as a result of uterine cancer. An evidence-based treatment regimen for patients with recognised CKD already exists and serves as a prerequisite for CKD screening programmes. Screening for CKD occurs in many contexts, including during routine care, within high-risk populations and in the general population. Population-based screenings must ensure follow-up and successful referral of test-positive individuals for appropriate diagnosis, treatment and counselling. Additionally, because screening in these different contexts entails different risks and benefits, informed patient choice is essential to a successful screening programme.