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Influence of Community-Based Kidney Screening on Chronic Kidney Disease Detection among Adults in Nigeria

Abstract

Chronic kidney disease remains an important public health concern among adults in Nigeria and may result from conditions such as hypertension, diabetes mellitus, glomerular diseases, recurrent infections, medication-related kidney damage, and other risk factors. Chronic kidney disease may progress gradually without obvious symptoms during its early stages, resulting in delayed diagnosis and treatment. Undetected kidney disease can eventually lead to severe complications, including kidney failure, cardiovascular disease, disability, and premature death. Early detection is therefore essential for identifying individuals at risk, initiating appropriate treatment, controlling underlying conditions, and slowing disease progression. Community-based kidney screening provides an opportunity to bring basic kidney health assessment closer to adults through community outreach programmes, primary healthcare centres, workplaces, markets, faith-based organizations, and other community platforms. Such screening may include blood pressure assessment, blood glucose testing, urine protein or albumin testing, serum creatinine measurement, estimated glomerular filtration rate assessment, and other appropriate kidney health evaluations. However, inadequate screening coverage, limited diagnostic equipment, shortages of trained healthcare personnel, financial barriers, low awareness, and weak referral systems may limit the effectiveness of community-based kidney screening programmes in Nigeria. Against this background, this study investigates the influence of community-based kidney screening on chronic kidney disease detection among adults in Nigeria. The study will be anchored on the Health Belief Model, Community Health Theory, and the Health Systems Framework. The Health Belief Model explains how adults' perceptions of susceptibility to kidney disease, perceived severity, perceived benefits of screening, perceived barriers, and cues to action may influence participation in kidney screening. Community Health Theory emphasizes the delivery of accessible health services through community structures and the involvement of communities in disease prevention, health promotion, and early detection activities. The Health Systems Framework emphasizes service delivery, health workforce, health information, medical products and technologies, financing, and accessibility as essential components of effective screening and healthcare programmes. Collectively, these theoretical perspectives provide a suitable framework for explaining how community-based kidney screening may influence chronic kidney disease detection among adults in Nigeria. The study will adopt a quantitative cross-sectional analytical or quasi-experimental research design. The study population will comprise adults aged 18 years and above residing in selected communities across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, households, and eligible adults. Community-based kidney screening will be measured using indicators such as availability of screening services, screening coverage, frequency of screening activities, accessibility of screening locations, number of adults screened, blood pressure assessment, urine protein or albumin testing, serum creatinine testing, estimated glomerular filtration rate assessment, availability of trained healthcare personnel, availability of screening equipment, and referral arrangements. Chronic kidney disease detection will be assessed using indicators such as abnormal kidney function test results, reduced estimated glomerular filtration rate, presence of albuminuria or proteinuria, newly identified suspected cases, confirmed chronic kidney disease cases where appropriate, stage of disease at detection, referral for further assessment, and initiation of appropriate management. Data will be collected using structured questionnaires, screening registers, laboratory records, healthcare facility records, community health records, referral records, and relevant programme documents. Descriptive statistics will be used to summarize participants' characteristics, screening coverage, kidney health findings, and patterns of chronic kidney disease detection. Inferential statistical techniques, including chi-square tests, correlation analysis, and logistic or multiple regression analysis, will be used to determine the influence of community-based kidney screening on chronic kidney disease detection. Where appropriate, detection rates before and after community-based screening activities may be compared to determine changes associated with the screening programme. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that community-based kidney screening has a significant positive influence on chronic kidney disease detection among adults in Nigeria. Adults who have access to community-based kidney screening are expected to have a higher likelihood of having previously undiagnosed kidney abnormalities or chronic kidney disease identified than adults without access to such services. Community-based screening may improve early identification of kidney dysfunction through accessible assessment of blood pressure, urine abnormalities, serum creatinine, and estimated kidney function. Early detection may provide opportunities for timely management of hypertension, diabetes, and other underlying conditions and may help slow the progression of kidney disease. Community-based screening may also improve public awareness of kidney health and encourage individuals at risk to seek appropriate medical care. Conversely, inadequate screening coverage, limited laboratory capacity, high screening costs, shortages of trained personnel, poor awareness, and weak referral and follow-up systems may reduce the effectiveness of community-based kidney screening. The study therefore expects accessible and well-organized community-based kidney screening to contribute significantly to improved detection of chronic kidney disease among adults in Nigeria. The study is expected to contribute to the literature on community-based kidney screening, chronic kidney disease detection, kidney health, non-communicable diseases, preventive healthcare, community health services, primary healthcare, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, primary healthcare centres, nephrologists, physicians, laboratory scientists, community health workers, kidney health programmes, development partners, and policymakers regarding strategies for improving early detection of kidney disease. The study will also provide evidence-based recommendations for expanding community-based kidney screening programmes, improving access to affordable kidney function testing, strengthening community health worker training, increasing public awareness of chronic kidney disease risk factors, integrating kidney screening into primary healthcare and non-communicable disease programmes, strengthening referral and follow-up systems, and improving access to appropriate treatment and long-term kidney care across Nigeria.

Keywords: Community-based kidney screening, chronic kidney disease detection, adults, kidney health, renal disease, kidney function, albuminuria, preventive healthcare, primary healthcare, Nigeria, non-communicable diseases, public health.