KEEP

About KEEP

WHAT IS THE KIDNEY EARLY EVALUATION PROGRAM (KEEP)?

KEEP is a free health screening program offered by the National Kidney Foundation (NKF) for individuals at increased risk of developing kidney disease.

WHAT ARE THE GOALS OF THE PROGRAM?
The goals of KEEP are to:

Raise awareness about kidney disease especially among “high risk” individuals
Provide free testing for people at increased risk for kidney disease
Encourage people “at risk” to visit a doctor and follow the treatment plan recommended
Provide educational information so that “at risk” individuals can prevent or delay kidney damage
Provide doctor referrals for follow-up care, if needed
Provide ongoing information and support

WHO SHOULD ATTEND A KEEP SCREENING?
You should attend a KEEP screening if you are 18 years or older and have one or more of the following:

Diabetes
High blood pressure
A parent, brother or sister with diabetes, high blood pressure or kidney disease

WHAT TAKES PLACE AT THE SCREENING?
One or more of these services will be provided to you at the screening:

Blood pressure, height, weight and waist circumference measurements
Blood and urine tests for signs of diabetes and kidney disease, including
- Blood glucose check blood sugar
- Hemoglobin check blood test for anemia
- Urine dipstick test for pyuria (white blood cells in urine)
- Urine dipstick test for hematuria (red blood cells in urine)
- Albumin to creatinine ratio (protein in urine)
- Serum creatinine (measures how well kidneys are filtering blood)
- Estimated Glomerular Filtration Rate (test for kidney function)
- Total cholesterol, HDL, LDL and triglycerides
- Some participants will also have their calcium, phosphorus, PTH and/or Hemoglobin A1c drawn

Test results are provided on site by a doctor or other qualified health professionals.
Free educational materials are also available.

WHAT HAPPENS AFTER THE SCREENING?
The National Kidney Foundation will:

Contact you with your results
With your permission, send your results to your doctor
Refer you to a doctor or public health facility, if needed
Provide additional information, education and support
Invite you back to attend a KEEP screening every year

HOW CAN I PARTICIPATE?

To obtain more information on KEEP and for a listing of Kidney Early Evaluation Programs (KEEP) taking place in your area, call the National Kidney Foundation at 1-800-622-9010 or visit www.KEEPonline.org

Understanding test values

All tests except the creatinine, hemoglobin, eGFR (Estimated Glomerular Filtration Rate), lipid panel, calcium, phosphorus, PTH and Hemoglobin A1c (if applicable) are done during the screening. A serum creatinine test to calculate your kidney function (eGFR), lipids test, and a hemoglobin test will be conducted by a lab. Individuals with an eGFR below 60 will have a calcium, phosphorus, and PTH conducted by the lab to assess bone health. Any participant with self-reported diabetes or blood sugar levels indicative of diabetes will have a Hemoglobin A1c done by the lab.

Blood Pressure: Blood pressure is the force your blood puts on the walls of your blood vessels as your heart works. Uncontrolled high blood pressure can cause heart disease, stroke, kidney disease and damage to the blood vessels. The guidelines presented in the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VII) are used in the KEEP program for classification of values and referral guidelines. The JNC VII classifications for adults 18 years and older are defined below.

The classification of prehypertension was created to increase the awareness of the possibility of developing hypertension so that measures, such as adopting a healthy lifestyle, can be taken to prevent high blood pressure.

Understanding Blood Pressure Reading

Systolic

Upper number (systolic) is less than 120 mm Hg ......... Normal

Upper number (systolic) is 120 - 139 mm Hg ......... Pre hypertension

Upper number (systolic) is 140 - 159 mm Hg ......... Hypertension (stage 1)

Upper number (systolic) is 160 mm Hg or greater ......... Hypertension (stage 2)

Diastolic

Lower number (diastolic) is less than 80 mm Hg ......... Normal

Lower number (diastolic) is 80 - 89 mm Hg ......... Pre hypertension

Lower number (diastolic) is 90 - 99 mm Hg ......... Hypertension (stage 1)

Lower number (diastolic) is 100 mm Hg or greater ......... Hypertension (stage 2)

Blood Glucose Check: Blood glucose is the concentration of sugar in the blood. This test is done to check for diabetes. A drop of blood placed on a glucose monitor is used to determine your glucose value. Glucose is the sugar in your blood.

Understanding Blood Glucose Reading

No known Diabetes	Known Diabetes
Fasting (Before eating) Less than 100 mg/dl Normal 100-125 mg/dl Impaired Fasting Glucose More than 125 mg/dl Indicates diabetes Non-Fasting (After eating) Less than 140 mg/dl Normal 140-199 mg/dl High 200 mg/dl and higher Indicates diabetes	Fasting (Before eating) Less than 70 mg/dl Below target range 70 - 130 mg/dl Within target range More than 130 mg/dl Above target range Non-Fasting (After eating) Less than 180 mg/dl Within target range More than 180 mg/dl Above target range

Albumin to creatinine ratio: The albumin to creatinine measurement estimates the amount of protein (albumin) found in your urine in a day and avoids the need to collect a 24-hour urine specimen. This test also helps measure for protein in the urine more accurately, since it corrects for differences in urine concentration.

Less than 30 mg/gm Normal

30 mg/gm or Greater Abnormal

Pyuria : The pyuria test checks for high level of white blood cells in the urine. Normally, white blood cells are not found in the urine. Urine is tested with a special dipstick to see if you are at risk for infection, inflammation and other abnormalities in the urinary tract.

Understanding Pyuria Reading

Negative Normal

Positive Abnormal

Hematuria: A dipstick test checks for red blood cells (blood) in the urine. Red blood cells are not normally found in the urine. Urine is tested with a special dipstick to see if you are at risk for kidney disease and other abnormalities in the urinary tract.

Understanding Hematuria Reading

Negative Normal

Positive Abnormal

Results for the following tests will be mailed to you within a few weeks.

Hemoglobin: A hemoglobin test is done to determine anemia or low red blood cell count. There are many reasons why the hemoglobin level can be low. Individuals with advanced kidney disease and poor kidney function can develop anemia.

Female: 12.0 - 15.6 gm / dl-Normal
<12 gm / dl-Low

Male: 12.6- 16.8 gm / dl-Normal
<12.6-Low

Lipid Panel

This test is used to evaluate your risk of heart disease and includes the measurement of cholesterol and triglycerides.

Total Cholesterol

Less than 200 mg/dl - Normal
Greater than 200 mg/dl - Elevated

HDL Cholesterol:
Less than 40 mg/dl – Undesirable
Greater than 60 mg/dl – Desirable

LDL Cholesterol:
Less than 100 mg/dl – Optimal
Greater than 160 mg/dl - Elevated

Triglycerides:

Less than 150 mg/dl - Normal
Greater than 150 mg/dl - Elevated

Estimated Glomerular Filtration Rate (eGFR): This test is used to get a better estimate of your kidney function. Your serum creatinine, age, race and gender are needed so we can provide this measurement to you.

≥90 ml / min / 1.73 m² Normal

≤90 ml / min / 1.73 m² Abnormal

Calcium, Phosphorus, PTH

Calcium, Phosphorus and PTH tests are being conducted to assess bone health, which may be related to kidney disease and/or other problems. The following blood tests will be done in an eGFR below 60 only.

Calcium - tests for levels of calcium in the blood
Phosphorus - tests for levels of phosphorus in the blood
PTH - test for levels of parathyroid hormone in the blood

Hemoglobin A1c (HbA1c)

This test will only be done on participants with self reported diabetes or blood sugar levels that indicate diabetes. Hemoglobin A1c evaluates blood glucose levels over a 6-8 week period.

Hemoglobin A1c:
≤ 7% - Normal
>7% - High