Participant Follow-up in the Kidney Early Evaluation Program (KEEP) After Initial Detection

Background: Chronic kidney disease (CKD) detection in a targeted at-risk population was reported in the National Kidney Foundation Kidney Early Evaluation Program (KEEP). This study assessed follow-up within 3 months of detection to determine whether participants reported seeing a physician, kinds of care addressed, and interventions. Methods: KEEP is a free community-based health-screening program to raise kidney disease awareness and detect CKD for early disease intervention. Participants receive laboratory results and educational materials about kidney disease risks and treatment options. Physicians receive laboratory results for their participating KEEP patients and clinical practice guidelines for CKD care. Results: Between August 2000 and December 2006, a total of 72,395 KEEP participants received follow-up forms. Forms were sent to all participants; the response rate was 28.4%. Responders were more likely to be older, women, white, living in the western United States, with high school education or higher, with decreasing kidney function by means of estimated glomerular filtration rate, and with hypertension, diabetes, or history of cardiovascular disease. Of respondents, 71% reported seeing physicians in follow-up. Those with evidence of CKD were 24% more likely to report seeing a physician than those without CKD. Follow-up with physicians was more likely with decreasing kidney function levels, increasing albuminuria, and more advanced CKD stage. Conclusion: The KEEP detection program with disease education appears to motivate the targeted population to seek physician care for findings noted. Longer term follow-up is needed to determine whether detection and physician follow-up lead to changes in care and outcomes that may affect the increased risk of death, end-stage renal disease, or cardiovascular events.