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논문분류	춘계학술대회 초록집
제목	Spotting Silent Kidney Disease: A Low-Cost Screening Initiative in LMICs
저자	Nikita Kumari
출판정보	2025; 2025(1):
키워드	kidney disease screening, task sharing, early detection
초록	Chronic kidney disease (CKD) is an emerging health concern in India, with limited early detection programs in rural and semi-urban areas. Haryana, like many states in India, faces challenges in identifying high-risk individuals due to resource constraints and lack of routine screening at the primary healthcare level. Given the strong association between CKD, hypertension, and diabetes, this pilot study aimed to evaluate the feasibility of a low-cost, targeted screening approach for early kidney disease detection in a primary healthcare setting in Haryana. Between 2022 and 2023, a pilot screening program was conducted in two community health centers (CHCs) in Haryana,India where eight trained non-physician healthcare providers (HCPs) assessed 1,250 individuals attending routine hypertension and diabetes clinics. Screening included self-reported medical history, blood pressure measurement, urine dipstick testing for proteinuria, and point-of-care serum creatinine analysis. Individuals with abnormal findings were counseled on risk factors and referred to district hospitals for further nephrology evaluation. Among the screened participants, 4.6% (n=57) had suspected kidney disease, with 85% being previously undiagnosed. Men were at higher risk (OR: 1.61, 95% CI: 1.19–2.04), and CKD was significantly associated with hypertension (OR: 2.33, 95% CI: 1.74–3.05) and high fasting glucose levels (OR: 2.56, 95% CI: 1.92–3.32). Proteinuria was detected in 3.4% (n=43), while 1.2% (n=15) had elevated serum creatinine levels. A total of 14 individuals required referral for specialist evaluation. This pilot study demonstrated that a simplified, high-risk screening strategy for kidney disease is feasible within Haryana’s existing primary healthcare infrastructure. Task-sharing with trained non-physician healthcare workersenabled cost-effective early detection without straining resources. The findings suggest that scaling up similar programs across LMICs could improve CKD diagnosis and management, particularly among individuals with hypertension and diabetes. Further studies are needed to refine screening protocols and optimize referral pathways for early intervention.
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