Relatives in silent kidney disease screening (RISKS) study: A Chinese cohort study

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The prevalence of chronic kidney disease (CKD) is increasing around the world. It is estimated that more than 5 million patients will require renal replacement therapy (RRT) by the year 2030.1 In response to this global health burden, different authorities had advocated the early detection and screening of kidney diseases in at‐risk population, which may allow timely intervention and hopefully delay the progression to end‐stage renal disease (ESRD).2
Apart from patients with traditional risk factors such as hypertension, diabetes, and cardiovascular diseases, those with a family history of CKD were also considered targets for screening.2 In fact, familial clustering of ESRD has been increasingly recognized. The presence of a first‐degree or second‐degree relative with ESRD was reported to increase the risk of developing ESRD by 3‐ to 5‐fold in Americans.4 In addition, subsequent studies revealed that a significant proportion of relatives of CKD patients had clinically ‘silent’ kidney diseases, which was manifested as asymptomatic proteinuria and/or microscopic haematuria.6 The reported prevalence of CKD in relatives of CKD patients ranged from 14% to 30%.6 These findings granted support to the need for screening in these individuals that may carry higher risks of developing CKD compared with the general population. However, the aforementioned studies enrolled mainly relatives of ESRD or dialysis patients.6 A large‐scale regional study that investigated the prevalence of CKD in first‐degree relatives of CKD patients in China may not be fully representative because more than half of index patients belonged to stage 5.8 It is also unclear whether the clinical characteristics of relatives are affected by the stages of CKD of index patients.
Since there is a limited study that evaluates the risk of CKD in close relatives of patients with earlier stages of CKD, the Hong Kong Society of Nephrology embarked on the present study to screen first‐degree relatives of CKD patients for the prevalence and risk factors for developing CKD in Hong Kong.
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