The KEEP Pakistan Initiative: Establishing a Kidney Early Evaluation Program in a Resource-Limited Setting — An Expert Survey and Proposed Framework

Shafiq Ur Rehman Cheema; Faiza Muzahir; Nawal Chishti; Muhammad Ahmed Abubakar

doi:10.53778/pjkd103374

Authors

Shafiq Ur Rehman Cheema Allama Iqbal Medical College
Dr. Faiza Muzahir Allama Iqbal Medical College , University of Health Sciences Lahore
Dr. Nawal Chishti Allama Iqbal Medical College , University of Health Sciences Lahore
Dr. Muhammad Ahmed Abubakar Allama Iqbal Medical College , University of Health Sciences Lahore

DOI:

https://doi.org/10.53778/pjkd103374

Keywords:

KEEP, high risk population, screening, Pakistan, chronic kidney disease, epidemiology, prevention

Abstract

Background: Chronic kidney disease is a major health burden all over the world including Pakistan where most of the cases remain undiagnosed at the community level. Kidney Early Evaluation Program (KEEP) in Pakistan offers a validated framework for target based community screening of kidney disease in resource limit settings.

Materials and methods: A structured questionnaire in the form of google form was sent to 24 medical experts. Respondents were asked to give their opinion and guidance about clinical and operational questions related to the implementation of KEEP initiative for early detection of chronic kidney disease in high risk population of Pakistan.

Results: About 80% of experts recommended chronic kidney disease screening using serum creatinine-based eGFR and spot urine albumin-to-creatinine ratio. Addition of urine complete examination for detecting glomerulonephritis was suggested by 70% experts, while 37% supported random blood sugar testing for diabetes screening. Most favored a combined screening strategy targeting high-risk groups, supported through sponsored funding. More than half also recommended screening individuals with recurrent kidney stones. Experts estimated that 40–50% of kidney disease cases remain undiagnosed in Pakistan. Most preferred screening in camps and hospital settings and were willing to participate in screening.

Conclusion: This survey provides us robust information about implementation of screening program for KEEP Pakistan. Targeting high risk individuals using a sponsored funded model for CKD screening is both feasible and urgently needed to address the silent epidemic of kidney disease in Pakistan.

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