Annual Screening for Chronic Kidney Disease using Urinary Dipstick to Detect Proteinuria among Elderly Patients with Hypertension and Diabetes Mellitus Attending Agbeke Mercy Medical Clinic, Oluyole Cheshire Home, Ibadan, Nigeria

Abstract

Background: Chronic kidney disease (CKD) is a highly prevalent medical condition throughout the world, with worsening indices in the developing countries. The economic burden with renal replacement therapy is something that most developing nations may find difficult to cope with. It is important for those at risk of CKD to be screened and identified early in order to prevent or slow progression to advanced stages. There are different screening methods for CKD, the acceptable minimum is an annual screening with the use of dipstick to detect urinary protein.

Methodology: For the first cycle of the audit, medical records of the elderly hypertensive and diabetic patients attending Agbeke Mercy Medical Clinic were obtained for a retrospective assessment of their annual urinalysis uptake. A ninety percent standard was set for the second audit cycle. This was followed by a three months prospective dipstick (Medi-Test Combi 10^® SGL) urinalysis screening, after health talks and a significant subsidization of the screening cost for all the participants were put in place.

Results: The records showed that 37% (32) of the eligible 87 patients had a dipstick urinalysis screening done in the preceding one year. In the three months, 93% (79) were screened for urinary protein with dipstick. 12.6% results were positive for at least 1+ of proteinuria.

Conclusion: Clinical audit is very important in improving clinical practice. It helps to identify areas of practice that may need improvement, as in this case annual screening for CKD with dipstick urinalysis, especially among patients who are at the risk of developing CKD. Despite financial constraints, efforts should be made to make CKD screening a routine in all at-risk patients