Using Peer Mentors to screen for CKD at dialysis units: Targeting high-risk family members

OBJECTIVE

The incidence of chronic kidney disease (CKD) is increasing and affects one in nine individuals in the United States. Genetics and lifestyle factors contribute to the incidence of CKD and serve as screening targets. We screened for predisposition to CKD at dialysis units in southeast Michigan, where obesity and hypertension are common. Families of dialysis patients, as well as non-relatives and staff, were evaluated. Peer Mentors with CKD participated in the screening.

METHODS

“Prevention Fairs” utilized inexpensive screening to determine a predisposition to CKD: urine dipstick for protein, glucose, or blood; BP > 140/90; and body mass index (BMI) > 30. Peer Mentor participation, honoring long-standing patients, and invitations to state legislators were included.

RESULTS

“Fairs” at 16 Michigan centers screened 497 individuals: 61% (305) had one finding, 18% (88) had two, and 6% (29) had three. Obesity was most common (220), and then hypertension (169), proteinuria (41), glycosuria (15), and hematuria (13). Although we had hypothesized that the highest risk would be found among genetic family members, positive screening was not statistically different between genetic relatives and other individuals. In addition, findings were distributed equally across varied demographic settings and races, underscoring the importance of social determinants of health.

DISCUSSION

Genetic factors are hypothesized to be predictors for CKD, but these results suggest that CKD risk may also be related to social determinants such as diet, exercise, health consciousness, socioeconomics, or cultural acceptance of obesity. Screening at dialysis centers, enhanced by participation of peers and social activities, contributes to referral for further treatment.