PMID- 36609330
OWN - NLM
STAT- MEDLINE
DCOM- 20230110
LR  - 20230201
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 13
IP  - 1
DP  - 2023 Jan 6
TI  - Leveraging the South African Diabetes Prevention Programme to screen for chronic 
      kidney disease: an observational study.
PG  - e068672
LID - 10.1136/bmjopen-2022-068672 [doi]
LID - e068672
AB  - OBJECTIVE: To evaluate the viability of leveraging an existing screening 
      programme (the South African Diabetes Prevention Programme (SA-DPP)) to screen 
      for chronic kidney disease (CKD), by assessing the yield of CKD cases among those 
      participating in the programme. DESIGN: Observational study conducted between 
      2017 and 2019. SETTING: 16 resource-poor communities in Cape Town, South Africa. 
      PARTICIPANTS: 690 participants, aged between 25 and 65 years, identified as at 
      high risk for type 2 diabetes mellitus (T2DM) by the African Diabetes Risk Score. 
      PRIMARY OUTCOME MEASURE: The prevalence of CKD among those participating in the 
      SA-DPP. RESULTS: Of the 2173 individuals screened in the community, 690 
      participants underwent further testing. Of these participants, 9.6% (n=66) and 
      18.1% (n=125) had screen-detected T2DM and CKD (defined as an estimated 
      glomerular filtration rate (eGFR) of<60 mL/min/1.73 m(2) and/or 
      albumin-to-creatinine ratio >3 mg/mmol), respectively. Of those with CKD, 73.6% 
      (n=92), 17.6% (n=22) and 8.8% (n=11) presented with stages 1, 2 and 3, 
      respectively. Of the participants with an eGFR <60 mL/min/1.73 m(2), 36.4% had no 
      albuminuria and of those with normal kidney function (eGFR >/=90 mL/min/1.73 m(2)), 
      10.2% and 3.8% had albuminuria stages 2 and 3, respectively. Of those with T2DM 
      and hypertension, 22.7% and 19.8% had CKD, respectively. CONCLUSION: The fact 
      that almost one in five participants identified as high risk for T2DM had CKD 
      underscores the value of including markers of kidney function in an existing 
      screening programme. By using an opportunistic approach to screen high-risk 
      individuals, those with CKD can be identified and appropriately treated to reduce 
      disease progression.
CI  - (c) Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - George, Cindy
AU  - George C
AUID- ORCID: 0000-0002-4561-0529
AD  - Non-Communicable Diseases Research Unit, South African Medical Research Council, 
      Cape Town, South Africa cindy.george@mrc.ac.za.
FAU - Hill, Jillian
AU  - Hill J
AD  - Non-Communicable Diseases Research Unit, South African Medical Research Council, 
      Cape Town, South Africa.
FAU - Nqebelele, Unati
AU  - Nqebelele U
AD  - Non-Communicable Diseases Research Unit, South African Medical Research Council, 
      Cape Town, South Africa.
AD  - Department of Medicine, University of Cape Town, Cape Town, Western Cape, South 
      Africa.
AD  - Department of Internal Medicine, University of the Witwatersrand, Johannesburg, 
      South Africa.
FAU - Peer, Nasheeta
AU  - Peer N
AD  - Non-Communicable Diseases Research Unit, South African Medical Research Council, 
      Cape Town, South Africa.
AD  - Department of Medicine, University of Cape Town, Cape Town, Western Cape, South 
      Africa.
FAU - Kengne, A P
AU  - Kengne AP
AD  - Non-Communicable Diseases Research Unit, South African Medical Research Council, 
      Cape Town, South Africa.
AD  - Department of Medicine, University of Cape Town, Cape Town, Western Cape, South 
      Africa.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20230106
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Humans
MH  - Adult
MH  - Middle Aged
MH  - Aged
MH  - *Diabetes Mellitus, Type 2/diagnosis/prevention & control/epidemiology
MH  - South Africa/epidemiology
MH  - *Renal Insufficiency, Chronic/diagnosis/epidemiology
MH  - Risk Factors
MH  - Glomerular Filtration Rate
MH  - Creatinine
PMC - PMC9827250
OTO - NOTNLM
OT  - epidemiology
OT  - nephrology
OT  - public health
COIS- Competing interests: None declared.
EDAT- 2023/01/08 06:00
MHDA- 2023/01/11 06:00
PMCR- 2023/01/06
CRDT- 2023/01/07 16:26
PHST- 2023/01/07 16:26 [entrez]
PHST- 2023/01/08 06:00 [pubmed]
PHST- 2023/01/11 06:00 [medline]
PHST- 2023/01/06 00:00 [pmc-release]
AID - bmjopen-2022-068672 [pii]
AID - 10.1136/bmjopen-2022-068672 [doi]
PST - epublish
SO  - BMJ Open. 2023 Jan 6;13(1):e068672. doi: 10.1136/bmjopen-2022-068672.