title: Longitudinal analysis of participants in the KEEP Mexico's chronic kidney disease screening program.
abstract: OBJECTIVE
  The Kidney Early Evaluation Program (KEEP) is a free screening and educational program aimed at detecting chronic kidney disease (CKD) among adult individuals who are at high-risk (those with diabetes, hypertension, or family history of these conditions or CKD). Confirmation of CKD diagnosis requires persistence of albuminuria or estimated GFR <60 mL/min for at least 3 months. We undertook this study to determine in a follow-up KEEP done at least 1 year after a baseline KEEP the following: 1) CKD incidence among individuals who initially tested negative for CKD, 2) transitions between CKD stages among individuals who initially tested positive for CKD.
  
  
  METHODS
  A random sample of KEEP participants was invited to participate in a follow-up KEEP between 2008 and 2010. Paired analyses were conducted to compare CKD stages between baseline and follow-up KEEP.
  
  
  RESULTS
  A total of 434 individuals with a mean age of 49 years and 77% females participated in the study. Overall CKD prevalence in the baseline KEEP was 24%, and most patients were unaware of the diagnosis. In the follow-up KEEP, CKD incidence was 14%. The percentage of patients who tested positive for CKD in the baseline KEEP and who remained positive regardless of stage in the follow-up KEEP was 40% for those with stage 1 at baseline, 52% for those with stage 2, 65% for those with stage 3, and 100% for those with stages 4 or 5.
  
  
  CONCLUSIONS
  Screening for CKD among high-risk individuals is uncommon. KEEP is an effective program for detecting CKD.
authors.affiliation: "Universidad Panamericana" School of Medicine, Mexico City, Mexico. Electronic address: gobrador@up.edu.mx.
authors.forename: Gregorio T
authors.initials: GT
authors.lastname: Obrador
authors.forename: Antonio R
authors.initials: AR
authors.lastname: Villa
authors.forename: Nadia
authors.initials: N
authors.lastname: Olvera
authors.forename: Verónica
authors.initials: V
authors.lastname: Gutiérrez
authors.forename: Daniela
authors.initials: D
authors.lastname: Contreras
authors.forename: Rebeca
authors.initials: R
authors.lastname: Reyes
mesh_terms: D000328:Adult; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control; D012307:Risk Factors
keywords: Chronic kidney disease; Diagnosis; Screening