This City’s CKD Stage ≥ 3 Incidence is Double The US National Average

A population-wide screening program deployed by mobile health units in Detroit, Michigan, found 11-13% had chronic kidney disease (CKD) ≥ stage 3, double the US population’s 6% reported national average.

Additionally, results from the cross-sectional study of the public health outreach program, which used the CKD-EPI 2021 eGFR creatinine formula, found increased incidence among at-risk subgroups, including older individuals, adults who identify as black, and patients with diabetes.

The Gap and Goal Behind CKD Screening in Disadvantaged Communities

“A lot of what we’re striving to do is just get people to want to know their numbers, want to know the information that’s going to lead them to think perhaps differently about prevention, or get awoken to do something more than nothing, which is going to be the only way to take a stage 3 chronic kidney disease patient and keep them off dialysis,” study investigator, Phillip Levy, an Assistant Professor of Emergency Medicine and Assistant Professor of Physiology at Wayne State University and the Assistant Vice President for Research at Wayne State University Department of Emergency Medicine, shared in an interview with HCPLive.

This community health program took place in Detroit, Michigan, where 31 to 34% of residents live below the federal poverty line, classifying these neighborhoods as disadvantaged. As such, a majority of individuals reside in environments with social determinants of health that put them at an increased risk for developing CKD. The major social barriers to screening for patients in these communities often remain awareness and access.

To address this, the population health program deployed mobile health units across metropolitan Detroit to improve earlier detection of cardiovascular-kidney-metabolic risk factors, decrease area-wide morbidity and mortality, and reduce health disparities.

How Did The Mobile Health Units Operate? What Did We Learn?

5 to 7 Mobile health units were deployed with nonphysician staff, 5 to 6 days per week, to partner locations. After they took a brief medical history, patients ≥ 18 years of age were offered screenings for high blood pressure (BP), diabetes (ie, hemoglobin A[HbA] measurement), and CKD using eGFR.

The cohort included 5128 unique patients with 5973 encounters. Investigators reported that 2293 patients (44.7%) had eGFRs of 60 to 89 mL/min/1.73 m2, whereas 579 (11.3%) had ≥ CKD stage 3(eGFR <60 mL/min/1.73 m2). As reported, patients with older age, Black race, and diabetes, defined as HbA1c ≥6.5%, were associated with higher risks for ≥ CKD stage 3

I think it’s critically important to recognize that when an older individual, an older Black individual, is found to have CKD, it didn’t happen yesterday. It’s been ongoing for a little while,” Levy said. “I’s really important for clinicians to not only impress upon their patients, but educate their patients to be ambassadors for their families and their communities—to say, you’re here, you’re doing the right thing by coming to the doctor’s office today, but what about your aunt, your uncle, your cousin, your mom, your dad?”

A limitation to these findings was an inability to measure urine albumin to creatinine ratio, which investigators suspect, if added, would result in increased rates of CKD stages.

Editor’s Note: Levy report relevant disclosures with Cielo Foundation.

References

1. Brook RD, Korzeniewski SJ, Foster B, et al. Screening for Chronic Kidney Disease by Mobile Health Unit Outreach. JAMA Network Open. 2026;9(3):e262312. doi:https://doi.org/10.1001/jamanetworkopen.2026.2312
2. Detroit Partnership on Economic Mobility. University of Michigan. Accessed April 16, 2026. https://poverty.umich.edu/projects/detroit-partnership-on-economic-mobility/