Table 2.
Wilson & Jungner screening criteria in the context of CKD screening (adapted from [48])
| 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. |
CKD chronic kidney disease, CVD cardiovascu lar disease, ESRD end-stage renal disease