The case for early identification and intervention of chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

TLDR

Chronic kidney disease causes significant global morbidity and mortality, disproportionately affects lower socioeconomic groups, yet lacks consensus and widespread adoption of early screening and management guidelines. The study seeks to establish early identification and treatment of CKD as an equity imperative. KDIGO convened a 2019 controversies conference to discuss early identification and intervention in CKD. The conference reached consensus that high‑risk individuals should receive immediate CKD screening, risk stratification, and treatment, ideally in primary or community care tailored to local contexts.

Abstract

Chronic kidney disease (CKD) causes substantial global morbidity and increases cardiovascular and all-cause mortality. Unlike other chronic diseases with established strategies for screening, there has been no consensus on whether health systems and governments should prioritize early identification and intervention for CKD. Guidelines on evaluating and managing early CKD are available but have not been universally adopted in the absence of incentives or quality measures for prioritizing CKD care. The burden of CKD falls disproportionately upon persons with lower socioeconomic status, who have a higher prevalence of CKD, limited access to treatment, and poorer outcomes. Therefore, identifying and treating CKD at the earliest stages is an equity imperative. In 2019, Kidney Disease: Improving Global Outcomes (KDIGO) held a controversies conference entitled "Early Identification and Intervention in CKD." A consensus emerged that CKD screening coupled with risk stratification and treatment should be implemented immediately for high-risk persons and that this should ideally occur in primary or community care settings with tailoring to the local context.