Towards population screening for kidney disease
Towards population screening for urinary protein loss: an implementation study testing two different approaches
This project evaluates an innovative screening technique to screen the general population for urinary protein loss, and to compare the yield of this screening with an existing technique. This project is a collaboration between the Dutch Kidney Foundation, the department of Kidney Diseases of the University Medical Center Groningen, E-Zorg BV (a KPN company), and Healthy.io Ltd (an Israeli e-health company).
Chronic kidney disease is a worldwide major public health problem that is associated with an increased incidence of kidney failure, leading to dialysis or transplantation, and also with an increased incidence of cardiovascular disease. Symptoms of kidney disease become noticeable late, therefore, at that time preventive measures will only have limited efficacy. Loss of protein in urine is an early marker of kidney damage, that is associated with several cardiovascular risk factors, such as high blood pressure, diabetes and high cholesterol. Population screening for urinary protein loss could therefore detect subjects with yet unknown risk factors for kidney and cardiovascular disease, who can benefit of early intervention.
Over 15.000 Dutch individuals will be invited to participate the screening. In this project two different screening approaches will be evaluated: a classic one, in which a urine sample will be collected at home and send to a central laboratory, and an innovative one, by using Healthy.io’s test kit and app. This kit consist of a dipstick for urinary protein loss, a urine cup and a patented color board. The app walks users through the test flow step by step. After testing, the app transfers the results to a e-health platform for clinical follow up. In case increased urinary protein loss is found, participants will be invited for an elaborate screening in which risk factors for kidney and cardiovascular disease will be measured.
Deliverables of this project include the evaluation of the yield of two screening techniques in terms of 1) participation rate, 2) usability, 3) number of subjects with increased protein loss with risk factors for chronic kidney and cardiovascular disease progression, and 3) cost-effectiveness. Overall, this project will give more insight in whether population screening for urinary protein loss can be applied in the Netherlands, and if so, which screening technique is the most (cost-)effective to use.