France – As part of Chronic Kidney Disease Prevention Week, medical biology group Biogroup offered free national screening on March 11 across its network’s 900 laboratories. Almost 25,000 patients spread across France could be tested on this occasion.
Screening and education of patients
In France, between 7 and 10% of the French population suffer from chronic kidney disease, ie approximately 6 million patients. “Most don’t know because it’s a silent disease,” he says dr Isabelle Riviere, Medical Biologist at Biogroup. For them, “this disease has all the criteria to benefit from a mass screening campaign. It is an irreversible pathology, but it can be treated early if caught early.”
Biogroup decided to launch a free national screening campaign across the network’s 900 laboratories on March 11.
To spread the word about the campaign, Biogroup sent out a newsletter to 35,000 physicians, issued press releases, broadcast same-day radio spots, and distributed 80,000 flyers in their labs featuring posters introducing the campaign.
The primary objective of this initiative was to assess renal function using glomerular filtration rate (GFR) in patients undergoing biological assessment on March 11 in the Biogroup network. The secondary objective was to educate the general public about early detection of kidney disease and kidney health. Two types of patients were studied: those who came to the lab for a routine test for which serum creatinine was requested and those who came to the lab for a blood test were offered a free serum creatinine test. Only non-hospitalized patients were included in this assessment. Consent was sought for patients whose serum creatinine was not prescribed.
1043 patients not informed about their kidney disease
The patient was then offered a questionnaire with three questions about known kidney disease, high blood pressure and diabetes. A total of 24,799 patients were offered screening. 94% of them had normal kidney function and 6% had low or abnormally low GFR. Patients with abnormally low GFR (GFR < 30) were mostly already aware of kidney disease (66%). But 33% of the patients were not aware of this, ie 24/73 patients. Likewise, 73% of patients with low GFR (30-60) were unaware of kidney disease, ie 1019/1405 patients. A total of 1043 (4.2%) patients who were unaware of the disease were warned thanks to the screening campaign.
In addition, the campaign showed that of the 4,937 patients with arterial hypertension, 455 (9%) had a GFR less than or equal to 60 and were not aware of kidney disease, while 248 (5%) had a GFR less than or equal to 60 and were aware of kidney disease. Of the 2414 diabetics, 217 (9%) were in the first case and 132 (5%) in the second case. “Diabetics and hypertensive patients begin to deteriorate in their kidney function at an early age (30-40 years), increasing the need for early detection,” notes Dr. Riviere. Regarding the geographical distribution of patients, the regions with the highest rate of patients with GFR ≤60 are the Grand-Est (9.3% of the analyzed patients), Hauts-de-France (9.1%) and Corsica ( 9.0%).
For the Prof Philippe Halfon, Medical and Scientific Director of Biogroup, “This first day of screening for kidney disease was a real success. Indeed, our study made it possible to identify more than 1000 patients with an undetected change in their kidney function.” Patients with abnormal GFRs were referred to their treating physician.
In fact, our study made it possible to identify more than 1000 patients with an undetected change in their kidney function.
Biogroup intends to repeat this event every year. “We want this to be a known date. We also need to raise awareness among GPs and the medical profession,” he believes.
Inform doctors about nephroprotection
For the Professor Luc Frimat, President of the French Society of Nephrology, Dialysis and Transplantation (SFNDT), “the concept of early detection is important. In fact, kidney protection is a very important goal in diabetics or those suffering from cardiovascular pathologies. We must do everything to ensure that the GFR remains stable and does not develop towards stage 3B or stage 4,” he emphasizes. However, screening for chronic kidney disease in the population eludes nephrologists. “It is mainly general practitioners who intervene, diabetologists or cardiologists. Nephrologists only admit patients if the GFR is less than 45.” For him, “non-nephrologists need to weigh the risk and understand the importance of protecting their patients’ kidneys”.
Non-nephrologists need to assess the risk and understand the importance of protecting their patient’s kidneys.
Biogroup’s action seems to him “commendable for raising awareness of this problem”, but he insists on the need for “real follow-up care for patients”. “You need at least 3 months between creatinine doses, so you have to follow this up,” he recommends. As far as the prospect of systematic screening in certain situations in diabetics or high blood pressure patients is concerned, he prefers to remain cautious: “Why not, but the sector must be organized efficiently and screening must be included in long-term monitoring. It is also necessary to provide the patient with the tools to understand what is happening, particularly through the establishment of therapeutic training,” he recommends.
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