The prevalence of CKD in Australian adults is approximately 16% with 2.4% having proteinuria and 7.8% CKD stages 3–5.25 Considering general untargeted screening of the population is not supported in Australia for its ineffective manner,7 the study demonstrated that early detection and optimal management of high blood pressure, diabetes and proteinuria in a primary care-based setting incorporating annual screening in 50–69 year olds, along with intensification of management in those already this website known to have these conditions, would be cost-effective and in some cases

highly cost-effective. Particular benefits of such a program, incorporated into an existing primary care system, lay in reducing cardiovascular and ESRD deaths, as well as reducing the number of people needing dialysis or transplantation.26 Another approach of opportunistic primary care-based targeted screening of high-risk

individuals is to conduct similar 5-Fluoracil nmr targeted screening programs in the community. A community-based detection program has been developed by Kidney Health Australia and piloted in the Australian workplace environment. Entitled KEY (Kidney Evaluation for You), the objectives were to test an effective and affordable means of finding early asymptomatic CKD in high-risk individuals within the community and referring them to a primary health-care provider for appropriate long-term care. The Tangeritin pilot studies have shown promising detection rates, however, further development of the KEY program and expansion into other community sites such as pharmacies and workplaces will depend on cost–benefit analysis. The most sustainable and effective approach appears to be opportunistic general practice screening, with the emphasis on early detection. The well-identified screening process of blood pressure, estimated GFR (eGFR) and urinary protein fits well with the developing approach to chronic disease, particularly given the ease of identification of the high-risk

groups, the simple tests needed to establish the presence and staging of CKD and the overlap of the action plans for CKD with those for best care of people with diabetes and cardiovascular risk reduction. However, for early detection and management of CKD to be successful in reducing the growing burden of CKD, substantial effort at education within primary care is required and subsequent treatment regimens will need to be broad-based for chronic disease management as a whole, and made cost-effective for the practitioner. Early detection of CKD is important for prevention and control of the disease. Studying the cost-effectiveness of the CKD prevention program may facilitate better management of the disease.