Screening for Chronic Kidney Disease in the Community Pharmacy. CRIERFAC Study: Description of the Methodology

Chronic kidney disease (CKD) is the existence of abnormalities in renal structure or function with an impact on health. This is usually considered when estimated glomerular filtration (eGF) falls under 60 mL/min/1.73m2. Its clinical course leads to renal replacement therapy (dialysis or transplant) when eGF falls under 15 mL/min/1.73m2. Screening in at risk populations has been proven to be cost-effective. The aim of this work is to perform CKD screening in the community pharmacy. In this publication we report and justify the methodology in detail.

Methodology: Pharmacists from the community pharmacies taking part selected patients who complied with inclusion and not exclusion criteria. Creatinine was measured by means of a finger prick and eGF calculated with the formula CKD-EPI. If this is lower than a set value, which depends on age, referral to the general practitioner takes place.

Results: a total of 141 out of 200 pharmacies took part in the study. In all 2116 patients were recruited and 116 patients were lost. The final sample size was 2000 patients.

Discussion: the protocol was successfully implemented by community pharmacists and was extremely well received by community pharmacy users. The age adjustment for eGF thresholds provides a novel additional filter. The aim is not to overburden primary care centres with potential referrals of false positives. Confirmation of the diagnosis is subject to voluntary communication by the patient to the pharmacist.