title: Mass screening for chronic kidney disease in rural and remote Canadian first nations people: methodology and demographic characteristics.
abstract: BACKGROUND
  Screening the general population for Chronic Kidney Disease is not currently recommended.. Rural and remote Canadian First Nations people suffer a disproportionate burden of Kidney Failure. The Fi rst N at i ons Community Based S creening to Improve Kidney He alth and Prevent D ialysis ( FINISHED ) project intends to test the hypothesis that a mobile, mass screening initiative available to all First Nations people 10 years of age and older residing in rural and/or remote communities, is feasible, will improve health outcomes and is cost effective.
  
  
  OBJECTIVE
  The objective of this manuscript is to describe the key elements required to design, implement and evaluate such a program and describe key characteristics of our screened cohort.
  
  
  METHODS
  Methods and cohort description.
  
  
  METHODS
  11 First Nations communities within 2 Tribal Councils in Manitoba, Canada.
  
  
  METHODS
  All First Nations individuals between the ages of 10-80 living in the 11communities were eligible for the screening initiative.
  
  
  METHODS
  Screening Rates achieved within communities.
  
  
  METHODS
  An interdisciplinary team partnership was established between the Diabetes Integration Project and the Manitoba Renal Program. Stakeholder consultation was obtained and protocols developed to mass screen community members using point of care testing equipment. All people screened were risk stratified, counselled and referred to nephrologists as required in real time, based on risk.
  
  
  RESULTS
  As of August 31, 2014, 1480 people in 11 communities over 2 Tribal Councils have been successfully screened. A mean screening rate of 21% of all community members eligible (aged 10-80) has been achieved. All patients at intermediate or high risk of kidney failure have been seen by nephrologists within 1 month of screening.
  
  
  CONCLUSIONS
  Long term outcomes of kidney failure rates not assessed for at least 5 years. Alternative public health initiatives to reduce kidney failure not investigated.
  
  
  CONCLUSIONS
  Point of care mass screening, real time risk prediction and counselling of First Nations people at high risk of Kidney Failure is feasible in rural and remote communities. Further analysis of this cohort will describe theepidemiology of CKD in these communities, and test the cost effectiveness of this strategy.
authors.affiliation: Diabetes Integration Project, Winnipeg, Canada ; University of Manitoba, Centre for Aboriginal Health Education, Winnipeg, Canada.
authors.forename: Barry
authors.initials: B
authors.lastname: Lavallee
authors.affiliation: Diabetes Integration Project, Winnipeg, Canada.
authors.forename: Caroline
authors.initials: C
authors.lastname: Chartrand
authors.affiliation: Diabetes Integration Project, Winnipeg, Canada.
authors.forename: Lorraine
authors.initials: L
authors.lastname: McLeod
authors.affiliation: Manitoba Renal Program, Winnipeg, Canada ; Department of Medicine, Section of Nephrology, University of Manitoba, Winnipeg, Canada ; Seven Oaks General Hospital Research Centre, Winnipeg, Canada.
authors.forename: Claudio
authors.initials: C
authors.lastname: Rigatto
authors.affiliation: Manitoba Renal Program, Winnipeg, Canada ; Department of Medicine, Section of Nephrology, University of Manitoba, Winnipeg, Canada ; Seven Oaks General Hospital Research Centre, Winnipeg, Canada.
authors.forename: Navdeep
authors.initials: N
authors.lastname: Tangri
authors.affiliation: Children's Hospital Research Institute of Manitoba, Winnipeg, Canada.
authors.forename: Allison
authors.initials: A
authors.lastname: Dart
authors.affiliation: Seven Oaks General Hospital Research Centre, Winnipeg, Canada.
authors.forename: Audrey
authors.initials: A
authors.lastname: Gordon
authors.affiliation: Diabetes Integration Project, Winnipeg, Canada ; University of Manitoba, Centre for Aboriginal Health Education, Winnipeg, Canada.
authors.forename: Stephanee
authors.initials: S
authors.lastname: Ophey
authors.affiliation: Manitoba Renal Program, Winnipeg, Canada ; Department of Medicine, Section of Nephrology, University of Manitoba, Winnipeg, Canada ; Seven Oaks General Hospital Research Centre, Winnipeg, Canada ; Seven Oaks General Hospital Kidney Health Program, 2300 Mcphillips Street, 2PD12, Winnipeg, MB R2V 3M3 Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Komenda
keywords: Chronic kidney disease; First nations health; Risk prediction; Screening