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Table 2 Wilson & Jungner screening criteria in the context of CKD screening (adapted from [48])

From: On the rationale of population screening for chronic kidney disease: a public health perspective

  Criteria Comment regarding CKD screening
1 The condition is an important health problem. CKD affects one in 10 adults worldwide. CKD increases the risk of all-cause and CV mortality and ESRD.
2 There should be an accepted treatment for patients with recognized disease Treatment would need to be adapted to the presence of risk factors and co-morbidities (e.g. hypertension, diabetes, CVD, etc.)
3 Facilities for diagnosis and treatment should be available. Diagnosis and treatment are routinely available in hospitals and health care centers.
4 There should be a recognizable latent or early symptomatic stage. CKD in its early stages (1–3) is almost always asymptomatic.
5 There should be a suitable test or examination. Serum creatinine, serum cystatin C and urinary microalbumin represent suitable tests to detect CKD.
6 The test should be acceptable to the population. Serum creatinine, serum cystatin C and urinary microalbumin are non-invasive and affordable tests.
7 The natural history of the condition, including development from latent to declared disease, should be adequately understood. Several cohort studies have shown a linear age-related decrease in renal function, but there are large inter-individual differences. People affected with CKD either die from CVD or develop ESRD (dialysis or kidney transplantation).
8 There should be an agreed policy on whom to treat as patients. There is high-quality evidence to recommend treatment with angiotensin II-receptor blockers in patients with CKD stages 1 to 3 [24], although evidence is lower in non-diabetic patients [58].
9 The cost of case-finding (including diagnosis and treatment of patients diagnosed) should be economically balanced in relation to possible expenditure on medical care as a whole. This would need to be determined within each health care system.
10 Case-finding should be a continuing process and not a “once and for all” project. Regular assessments of renal function would be quite easy to put in place.
  1. CKD chronic kidney disease, CVD cardiovascu lar disease, ESRD end-stage renal disease