title: Insights from Screening a Racially and Ethnically Diverse Population for Chronic Kidney Disease.
abstract: BACKGROUND
  The value of chronic kidney disease (CKD) screening in the general population remains unclear but may be beneficial in populations with high disease prevalence. We examined risk factors for albuminuria among participants in a state-wide CKD screening program in Hawaii.
  
  
  METHODS
  The National Kidney Foundation of Hawaii Kidney Early Detection Screening (NKFH-KEDS) program held 19 CKD screening events from 2006 to 2012. Participants rotated through 5 stations during which sociodemographic, blood glucose, urine albumin-to-creatinine ratio (ACR), and spot urine albumin data were collected. Multivariate logistic regression analyses (adjusted for age, sex, race/ethnicity, body mass index [BMI]) were used to identify clinical predictors of abnormal ACR (≥30 μg/mg) and abnormal spot urine albumin (>20 mg/L) levels.
  
  
  RESULTS
  Among 1,190 NKFH-KEDS participants who met eligibility criteria, 13 and 49% had abnormal ACR and urine albumin levels, respectively. In multivariate logistic regression analyses, participants of older age (>65 years), Asian and Pacific Islander race/ethnicity, BMI ≥30 kg/m2, and with hypertension had higher risk of abnormal ACR. Being of older age; Asian, Pacific Islander, and Mixed race/ethnicity; and having diabetes was associated with higher risk of abnormal urine albumin levels in adjusted analyses.
  
  
  CONCLUSIONS
  NKFH-KEDS participants of older age; Asian and Pacific Islander race/ethnicity; and with obesity, hypertension, and diabetes had higher risk of kidney damage defined by elevated ACR and urine albumin levels. Further studies are needed to determine whether targeted screening programs can result in timely identification of CKD and implementation of interventions that reduce cardiovascular disease, death, and progression to end-stage renal disease.
authors.affiliation: Department of Surgery, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii.
authors.forename: Linda L
authors.initials: LL
authors.lastname: Wong
authors.forename: Kamyar
authors.initials: K
authors.lastname: Kalantar-Zadeh
authors.forename: Victoria
authors.initials: V
authors.lastname: Page
authors.forename: Glen
authors.initials: G
authors.lastname: Hayashida
authors.forename: Amy S
authors.initials: AS
authors.lastname: You
authors.forename: Connie M
authors.initials: CM
authors.lastname: Rhee
mesh_terms: D000328:Adult; D000368:Aged; D000418:Albumins / Q000032:analysis; D000419:Albuminuria / Q000175:diagnosis; D015992:Body Mass Index; D015331:Cohort Studies; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D006254:Hawaii; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis* / Q000208:ethnology*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D012307:Risk Factors; D012955:Societies, Medical
chemical_list: D000418:Albumins; D003404:Creatinine