Impact of Integrating Chronic Kidney Disease Screening in Occupational Medicine Visits: A Pilot Experience in Senegalese Private Sector Workers

Abstract

 Introduction: Chronic kidney disease (CKD) represents an important cause of death and a burden on health systems particularly in low-income countries. To fight this epidemic early detection and primary prevention in at-risk population are recommended but in many African countries, they are inexistent. In this study we assessed the interest of integrating CKD screening in routine medical visits of private sector workers in Dakar. Methods: We conducted a cross-sectional survey in two major private companies who provided regular medical check-up to their employees. Data were collected during annual medical visits. Prevalence of chronic kidney disease (CKD) and additional costs related to renal screening were calculated. Statistical analyses were performed with SPSS 16.0. Results: We included 402 adults (266 men and 136 women) with a mean age of 46.2 ±7.6 (23-75). The mean estimated glomerular filtration rate was 99.8±23.5 ml/min/1.73m² (ranges 35.7-133.5 ml/min/1.73m²). Prevalence of CKD was 22.4% (22.2 % in women versus 22.8 % in men). Albuminuria was present in 5.5% of them. Hypertension was found in 12.1% of patients and prevalence of diabetes was 9.7% and 16.8% for obesity. Introduction of systematic renal screening helped to detect 90% CKD patients who had no clinical symptom even in those with diabetes and/or high blood pressure. Additional cost of the renal tests was estimated to 03 USD per worker yearly. Risk factors associated with low eGFR were age (OR= 1.15, 95% CI= 1.02 - 2.45; p=0.02) and systolic blood pressure (OR= 1.82, 95% CI=1.10 - 4.36; p=0.03). Conclusion: Despite limited sample size, this study demonstrates that opportunistic screening activities in specific socio-professional groups are helpful alternative in absence of national screening and prevention program.