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What approach would you take for primary, secondary, and tertiary prevention of this condition/disorder/disease?
Throughout all stages of prevention, it is crucial to emphasize patient education, shared decision-making, and collaboration with multidisciplinary teams.
Primary prevention includes regular monitoring, evaluation, and adaptation of prevention strategies based on emerging evidence and population needs are also essential for effective chronic kidney disease (CKD) prevention and management. Prevent hypertension with early diagnosis and treatment.
Secondary prevention includes modifying lifestyle factors such as diet/nutrition management, obesity/body mass index, and physical activity/exercise, and can measures will decrease the disease burden (Yin, et al, 2022). These measures also include collaborating with multidisciplinary teams and encouraging participation in trials. Engaging in good lifestyle practices may potentially prevent the progression of CKD (Cardol, et al. (2022).
Tertiary prevention is participating and implementing evidence-based treatment protocols, providing comprehensive care, palliative care, and end-of-life care and conducting research and quality improvement interventions.
2. What approach (test/s) would you take for screening and diagnostic testing of this condition/disorder/disease?
Regular monitoring of kidney function can be conducted by following the below tests, screenings, and diagnostic tests for chronic kidney disease (CKD)
Review the medical history,
Conduct a physical examination,
Order and evaluate lab tests including creatinine levels, estimated glomerular filtration rate, blood urea nitrogen (BUN), cystatin C level, urinary albumin levels, Urine albumin-to-creatinine ratio (UACR) or protein-to-creatinine ratio (PCR)
Kidney imaging tests: Imaging tests like ultrasound, CT scan, or MRI
Kidney biopsy
3. What recommendations, if any, are in place from the United States Preventative Services Task Force about this condition/disorder/disease?
Public health initiatives aimed at raising awareness, promoting healthy lifestyles, and improving access to healthcare services are essential to mitigate the burden of CKD on individuals and society
The USPSTF is currently updating its recommendations concerning CKD. Based on pass USPSTF recommends screening for CKD in adults aged 18 years or older who have risk factors for CKD, such as diabetes, hypertension, cardiovascular disease, or a family history of CKD. Due to a lack of evidence, the USPSTF has not issued any recommendations regarding screening for CKD in children and adolescents. help prevent or delay the progression to end-stage renal disease (ESRD) and associated complications
4. What test is best in terms of specificity and sensitivity, and why for a condition/disorder/disease?
The best CKD test is the Estimating Kidney Function (eGFR) test, which has high specificity and sensitivity, thorough validation, and full patient factor inclusion. It gives a complete kidney function and disease progression assessment when utilized with UACR and serum cystatin C.
It gives a complete kidney function and disease progression assessment when utilized with UACR and serum cystatin C.
Reference
Bartol.,T. (2015). Thoughtful use of diagnostic testing: Making practical sense of sensitivity, specificity, and predictive value. The Nurse Practitioner, 48, 8-10.
Cardol, C. K., Boslooper-Meulenbelt, K., van Middendorp, H., Meuleman, Y., Evers, A. W. M., & van Dijk, S. (2022). Psychosocial barriers and facilitators for adherence to a healthy lifestyle among patients with chronic kidney disease: a focus group study. BMC Nephrology, 23(1), 1–16. https://doi.org/10.1186/s12882-022-02837-0
United States Preventative Services Task Force (2023) Recommendation: Chronic Kidney Disease: Screening | United States Preventive Services Taskforce (uspreventiveservicestaskforce.org)
Yin, T., Chen, Y., Tang, L., Yuan, H., Zeng, X., & Fu, P. (2022). Relationship between modifiable lifestyle factors and chronic kidney disease: a bibliometric analysis of top-cited publications from 2011 to 2020. BMC Nephrology, 23(1).
