Background Chronic kidney disease (CKD) is a condition presenting with long-term slow progression of structural and/or functional damage to the kidneys. Early detection is key to improved outcomes. Point-of-care eGFR screening technology allows for detection of abnormal kidney function in the community pharmacy setting.
Purpose To evaluate the effectiveness of a community pharmacist-directed point-of-care screening programme and to identify the prevalence of CKD in high-risk patients.
Material and methods Patients with at least one CKD risk factor were identified at four community pharmacies in British Columbia. They provided a sample of peripheral blood via a self-administered finger-prick and analytical data to assess kidney function that was reported including BUN, serum creatinine, and electrolytes by the HealthTab screening system. The eGFR was calculated according to the CKD-EPI formula. Once results were available the pharmacist conducted a comprehensive review with the patient and recommended certain follow-up actions if appropriate.
Results Six-hundred and forty-two participants were screened over a 6 month period. Mean age was 60 years and females accounted for 55% of the study population. CKD risk factors included diabetes (30%), hypertension (45%), cardiovascular disease (12%), family history of kidney disease (13%), age over 55 years (68%) and an Aboriginal, Asian, South Asian or African ethnic background (82%). 11.5% of patients had eGFR values lower than 60 mL/min (abnormal renal function) and 34% had an eGFR between 60 mL/min and 89 mL/min (minimally reduced renal function). Overall pharmacists’ actions included blood pressure check (98%), education on CKD and risk factors (89%), medication review (72%) and physician follow-up (38%).
Conclusion These results illustrate the prevalence of abnormal renal function among undiagnosed, high-risk patients in the community. Pharmacists, as the most accessible healthcare practitioners, are ideally positioned to utilise novel point-of care technologies to improve access to CKD screening and increase awareness around the importance of early detection.
References and/or acknowledgements This project was funded through a partnership between the BC Ministry of Health and The Kidney Foundation of Canada.
No conflict of interest.
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