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Screening campaign targets elusive kidney disease

Chronic kidney disease, an insidious illness that typically escapes notice until it becomes serious, is to be tracked under a free scheme starting today through a healthcare partnership.

The disease is closely linked to dialysis, which accounts for a comparatively high percentage of the island’s population, according to Claire McDevitt, the chief executive of the consulting firm Healthcare Solutions.

It has launched free screening in tandem with the Boston-based Carna Health, a digital health company.

The CKD programme, backed by the Ministry of Health, comes with funding from the Bermuda Health Council.

Starting with a series of lifestyle questions, it can refer potential CKD patients to testing that can establish the presence and severity of the disease.

Ms McDevitt said Carna Health could also provide a monitoring app putting people in better control of their health.

“Carna hopes to shed light on the nearly 90 per cent of people who have CKD but don’t know it,” she said.

“Identifying undiagnosed kidney-related disease through the Carna testing platform is a substantial leap forward.”

Three dates for screening through the Bermuda Diabetes Centre and Omni Medical are already full, with more dates to be set up in 2024.

Ms McDevitt urged would-be candidates to sign up via the e-mail bermuda@carna.health.

Potential hosts for a screening session can register on the Carna Health website.

She said of CKD: “It can progress silently or with only minimal symptoms until later stages where interventions may be less successful and may lead to haemodialysis or transplant.”

Of the island’s patients with CKD, only 7 per cent are stage 1 or 2, while 20 per cent are at the more advanced stage 4 or 5, meaning diagnosis is “skewed” to later in its progression.

Warding off the illness comes with lifestyle change, she added: weight loss, exercise and controlling blood sugar.

Those with CKD can also take medications to control diabetes and high blood pressure, and drugs to prevent or delay the need for dialysis.

She summed up the best way to tackle CKD as: “Raise awareness, prevent progression, implement timely therapy.”

Residents first undertake a series of questions to learn if they are a candidate, either with a healthcare provider or by themselves.

Questions range from the presence of diabetes, hypertension and cardiovascular disease, to obesity, smoking and family history.

Aside from helping potential patients, the screening will yield a better picture of the extent of CKD.

Ms McDevitt said: “We can identify patients in earlier stages and direct the appropriate patients to nephrology.

“We will also track patients to make sure they are getting follow-up testing and referrals to specialists when needed.”

She added: “Given data from the BHeC and known high rates of dialysis, we suspect that the prevalence is very high.

“Diabetes, hypertension and obesity are known risk factors and also it is highly suspected that genetic predisposition may contribute — this work is yet to be completed on the island.”

Until recently, the diagnosis of CKD required central laboratory testing which Ms McDevitt said was “neither convenient nor scalable for population screening and close monitoring”.

Carna’s digital platform links users to simple finger-prick and urine tests.

“At-risk patients identified in this process can be tested remotely in community centres, clinics, health fairs and pharmacies through a Bluetooth-enabled smartphone app with real-time results available at the time of screening.

“Patients of all stages can use the Carna app to monitor their status and will be guided to the appropriate kidney specialist as needed so the ideal therapy can be started at the appropriate time with the goal of preventing the need for dialysis or transplant.”

Patients who consent to having their data shared will also enable tracking of CKD in the population.

Ms McDevitt said: “These data sets will drive predictive machine-learning and can provide insights into the probability that someone will develop CKD, while also identifying the main factors contributing to such risk.”

She said more programmes would be launched next month in Cameroon, followed by a string of African countries in the 2024, along with Serbia and Poland.

Point-of-care testing in Britain, backed by the National Health Service, is to launch by mid-to-late 2024.

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Published November 30, 2023 at 7:54 am (Updated November 30, 2023 at 7:54 am)

Screening campaign targets elusive kidney disease

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