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Abstract

Background:

Chronic kidney disease (CKD) is often asymptomatic in early stages, making community screening initiatives crucial. This study describes a comprehensive awareness and screening initiative during World Kidney Day 2025 in Gdańsk, Poland. The objectives were to: (1) evaluate the feasibility and effectiveness of a collaborative community-based CKD screening and health education model, (2) determine the prevalence of decreased estimated Glomerular Filtration Rate (eGFR <60 mL/min/1.73 m²) using 3 different estimation equations, (3) analyze discrepancies between self-reported and objectively measured obesity as a CKD risk factor, (4) assess the usability of point-of-care creatinine testing device (Nova Max Pro Creatinine and eGFR Meter) in community screening settings, and (5) formulate recommendations for optimizing future community-based kidney health screening initiatives based on implementation experience.

Methods:

A collaborative event was organized by the Medical University of Gdańsk and the University of Gdańsk at a local shopping center. Trained volunteers administered CKD risk factor questionnaires, performed blood pressure measurements, and conducted capillary blood creatinine testing with on-site eGFR calculation using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) 2009 equation. Participants received educational materials, urine test strips, and nutritional information. Data were subsequently reanalyzed using CKD-EPI 2021 and European Kidney Function Consortium (EKFC) equations.

Results:

171 participants (67.3% women, median age 63 years) were screened. Self-reported risk factors included hypertension (38.6%), obesity (18.7%), nonsteroidal anti-inflammatory drugs (NSAIDs) use (16.4%), cardiovascular disease (15.8%), smoking (15.8%), family history of kidney disease (15.2%), and diabetes (11.1%). Decreased eGFR (<60 mL/min/1.73 m²) was identified in 4.1% (CKD-EPI 2009), 2.9% (CKD-EPI 2021), or 5.8% (EKFC) of participants. Among 86 participants with measured body mass index (BMI), 9.3% were unaware of their obesity despite BMI ≥30 kg/m². Furthermore, volunteers described the Nova Max Pro Creatinine and eGFR Meter as very easy to use. Recommendations for future community-based kidney health screening initiatives were formulated.

Conclusions:

Community-based CKD screening using a collaborative academic model is feasible and effective for combined early detection and health education initiatives. The substantial variation in detection rates between eGFR formulas necessitates careful equation selection, with CKD-EPI 2009 remaining optimal for European populations. Self-assessment proves unreliable for identifying obesity as a CKD risk factor, requiring objective measurements. Point-of-care creatinine testing demonstrates high usability for community settings. Future initiatives should prioritize demographic diversification, standardized anthropometric measurements, and multi-modal educational approaches to optimize early CKD detection and prevention efforts.

Keywords

diagnostic screening programs World Kidney Day renal failure health promotion prevention

Introduction

World Kidney Day (WKD) is an annual global event dedicated to raising awareness about kidney health, supporting renal patients, and recognizing the work of nephrologists worldwide. It was first established in 2006 as a joint initiative of the International Society of Nephrology (ISN) and the International Federation of Kidney Foundations – World Kidney Alliance (IFKF-WKA).¹

Since its inception, the initiative has significantly contributed to increasing public awareness of the risk factors associated with kidney diseases and their impact on overall health. Each year, official reports summarizing the global activities of WKD are published and made available on the campaign’s website.² Local organizing committees worldwide have undertaken a wide variety of awareness campaigns. These have included activities such as rowing competitions, sculpting kidneys from ice, radio broadcasts, social media quizzes, and art contests for children, to name a few from many activities described on the WKD website.³ An important component of the initiative is also the organization of preventive health screenings, aimed at early detection of kidney-related conditions and promoting proactive management of kidney health.

The 2025’s WKD was focused on the significance of early screening in populations at high-risk of chronic kidney disease, which resonated in its theme: “Are Your Kidneys OK? Detect early, protect kidney health.” In order to target individuals with a high probability of deterioration of renal function, 8 factors that may contribute to chronic kidney disease were specified:

1) Increased body mass index (BMI) (obese individuals have 28% higher risk of kidney disease⁴),

2) healthy diet and reduced salt intake (i.e., higher salt intake is shown to increase odds of CKD by 21%),⁵

3) diabetes mellitus (DM; i.e., compared to individuals without DM, those with the condition have a nearly 2-fold increased risk of developing CKD)⁶

4) hypertension,

5) fluid restrictions (lower fluid intake is associated with a higher incidence of CKD),⁷

6) smoking (ever smokers have 18% increased odds of CKD),^5,8

7) nonsteroidal anti-inflammatory drugs (NSAIDs, i.e., 32% greater risk of CKD in patients taking NSAIDs for more than 90 days and 18% for people who took at least once a day but for a shorter period of time),⁹

8) family history of CKD.

As a part of a preventive strategy, the WKD Steering Committee announced 8 golden rules for kidney health promotion: healthy diet, adequate hydration, physical activity, blood pressure monitoring and control, glycemic monitoring and control, avoidance of nicotine, avoidance of regular use of NSAIDs, and targeted testing for those with risk factors. The 2025 WKD campaign was also joined by the faculty members and students of the Medical University of Gdańsk and the University of Gdańsk.

The prevalence of CKD among Polish adults (ages 18-79) was estimated at 5.8% (approximately 1.7 million patients) in 2011, and was accompanied by low awareness of this condition (14.9%).¹⁰ However, over time, the prevalence of CKD is increasing.¹¹ In a recently published Polish study, the prevalence of CKD in primary care patients aged 60 to 75 years or younger patients with risk factors (hypertension, diabetes, cardiovascular disease, obesity) was 14.2%.¹² The prevalence rises even higher in the elderly, to 26.9% in those aged 75 and older.¹³ Despite high prevalence, disease awareness remains remarkably low (3.2% among affected individuals in the PolSenior study conducted in the years 2007 to 2011,¹⁴ 14.9% in NATPOL 2011¹⁰, and 17.0% in WOBASZ studies.¹³ Hence, the Polish population is highly relevant for community-based CKD screening and health education.

This study aimed to: (1) evaluate the feasibility and effectiveness of a collaborative community-based CKD screening and health education model, (2) determine the prevalence of decreased eGFR (<60 mL/min/1.73 m²) using 3 different estimation equations (CKD-EPI 2009, CKD-EPI 2021, EKFC) and assess agreement between formulas, (3) quantify discrepancies between self-reported and objectively measured obesity as a CKD risk factor, (4) assess the usability of point-of-care creatinine testing device (Nova Max Pro Creatinine and eGFR Meter) in community screening settings, and (5) formulate recommendations for optimizing future community-based kidney health screening and education initiatives based on implementation experience.

Methods

WKD 2025 in Gdańsk was organized as a community-focused, joint initiative of the Medical University of Gdańsk and the University of Gdańsk. The event received the patronage of the rectors of both universities. As a part of the international WKD celebration, the event was pinned to the official map of the WKD 2025 activities and promoted widely. Information about the event could be found in social media (dedicated Facebook profile, Facebook event, and posts), 2 local radio stations, as well as in the popular local news agency (listed in Supplementary materials, Table S1). Moreover, traditional posters were displayed across the campuses of the organizing parties.

Volunteers were recruited among members of the scientific circles from the Medical University of Gdańsk and the University of Gdańsk. They were informed that no financial compensation is offered. Based on their availability, the event schedule was prepared. An important part of the volunteer recruitment process was ensuring that all volunteers could provide basic information on kidney disease risk factors and key prevention strategies. On March 10, 2025, volunteering students had an online training session conducted by an internal medicine specialist. The training covered topics such as kidney anatomy, function, common diseases, as well as treatment and prevention. The meeting was especially beneficial for the non-medical students, as it allowed them to better understand CKD and the importance of its prevention. Therefore, they could take not only active, but also informed participation in the event.

On March 13, 2025, measurements were conducted at the Madison Shopping Center in Gdańsk as part of the WKD event. The stall setup began 2 h before the event’s launch. Volunteering students received a briefing, and 2 measurement stations were prepared (i.e., blood pressure measurement and capillary blood creatinine measurements). The stall was operating from 12 PM to 7 PM. Students received certificates for their volunteering.

Convenience sampling was used. Sample size calculation was not performed as all adult passersby, regardless of gender, were encouraged to participate. The inclusion criterion was being aged 18 and above.

In addition to educating participants on the epidemiology, risk factors, and diagnostics of kidney disease, the event included arterial blood pressure measurements and capillary blood creatinine testing. All blood pressure and creatinine measurements were performed by medical students from the Medical University of Gdańsk, as well as by an internal medicine specialist, all of whom were actively involved in organizing the WKD activities. Prior to undergoing the measurements, assisted by volunteers from the University of Gdańsk, participants completed a brief questionnaire (6 items) on demographic information and assessing individual risk factors for kidney disease (Supplementary materials, Table S2). Afterward, volunteers offered free at-home urine test strips (test interpretation was available through QR code) and informed about nutritional resources available on the Narodowe Centrum Edukacji Żywieniowej website [the Polish Center for Nutrition Education¹⁵ (website address was stored under another QR code). Following these procedures, participants underwent blood pressure measurement and capillary creatinine testing. Throughout the event, volunteers were supervised by an internal medicine specialist from the Medical University of Gdańsk and a psychologist from the University of Gdańsk.

Blood Pressure Measurement

Blood pressure was measured, following the principles of the 2024 European Society of Cardiology (ESC) Guidelines where feasible in the shopping mall environment.¹⁶ Participants were advised to rest in a seated position for at least 5 min. Clothing was removed from the upper arm to allow proper placement of the cuff. Participants were instructed to avoid talking, moving, or tensing muscles during both the rest period and the measurement itself. During the measurement performed using an automated oscillometric device, participants sat on a chair with back support, with feet flat on the floor and legs uncrossed. An appropriately sized cuff was selected based on the circumference of each participant’s arm and positioned approximately 2 cm above the antecubital fossa. Due to the shopping mall setting and time limitations, certain guideline recommendations, such as ensuring complete silence during measurement or performing multiple readings on both arms, could not be fully implemented.

Capillary Blood Creatinine Measurement

Capillary creatinine testing was performed using the Nova Max Pro Creatinine and eGFR Meter (Nova Biomedical, USA). Prior to each blood collection, the participant’s age, sex, and ancestry were entered into the device.

A single-use 21G and 23G lancets were used to puncture the fingertip, and in accordance with the manufacturer’s instructions, 1.2 µL of whole capillary blood was applied to a disposable test strip. The analyzer produced a creatinine result within 30 s. The built-in software then automatically calculated the estimated glomerular filtration rate (eGFR) using the CKD-EPI equation. During the event, the older version of the CKD-EPI equation (2009), taking into account the ancestry, was used since it provides better accuracy in European populations and lower risk of missing high-risk patients, particularly among the elderly and those with diabetes or cardiovascular disease, compared to the 2021 version.¹⁷

Data Collection and Management

Data collected on paper forms during the event, as well as creatinine concentration and eGFR (CKD-EPI 2009) from the measuring devices, were transcribed into an Excel spreadsheet. The accuracy of data transfer between the creatinine measurement devices and paper records was verified to ensure data integrity. After the event, all users included medical students (n = 5) and 1 internal medicine specialist who operated the device during the screening event were asked online to evaluate their experience with the device on a 5-point Likert scale ranging from “very easy” to “very difficult.”

Estimated Glomerular Filtration Rate Calculation

The estimated glomerular filtration rate was calculated using 3 different methods. The European Kidney Function Consortium (EKFC) equation was applied using the online calculator available at https://ekfccalculator.pages.dev (access date: 03.04.2025). The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI 2009 and 2021) equation calculations were performed in Excel spreadsheet.

Statistical Analysis

Data were cleaned in Microsoft® Excel® (Microsoft 365) and subsequently analyzed using Jamovi software (version 2.6.26). Due to substantial deviations from normal distribution, continuous variables were described using median and interquartile range (IQR). Binary variables were presented as counts and percentages [n (%)]. Differences between genders were assessed using Pearson’s χ² test for categorical variables and the Mann-Whitney U test for continuous variables. Statistical significance was set at P < .05 (2-tailed) for all analyses.

Results

Participants Description

A total of 171 participants (115 women [67.3%] and 56 men [32.7%]) were included in the study and underwent capillary creatinine measurement. The median age of participants was 63 years (interquartile range [IQR]: 46-72 years; range: 18-90 years). Several self-reported, non-exclusive risk factors for chronic kidney disease (CKD) were identified among the study population (n = 115, 67.3%): hypertension was the most prevalent (n = 66, 38.6%), followed by obesity (n = 32, 18.7%), use of NSAIDs (n = 28, 16.4%), cardiovascular disease and smoking (both n = 27, 15.8% each), family history of kidney disease (n = 26, 15.2%), and diabetes mellitus (n = 19, 11.1%). The distribution of these risk factors did not differ significantly between genders (all P > .05); details are presented in Table 1. In addition, 56 (32.7%) participants did not present any of the self-reported risk factors.

Table 1.

Study Participants Characteristics.

Self-reported characteristic	All	Women	Men	P value
Age, median (IQR)	63 (46-72)	62.5 (49-71)	63 (38.5-76)	.76
Diabetes mellitus, n (%)	19 (11.1)	13 (11.2)	6 (10.9)	.95
Hypertension, n (%)	66 (38.6)	42 (36.2)	24 (43.6)	.35
Obesity, n (%)^a	32 (18.7)	20 (17.5)	12 (21.8)	.51
Heart diseases, n (%)	27 (15.8)	15 (12.9)	12 (21.8)	.14
Smoking, n (%)	27 (15.8)	18 (15.5)	9 (16.4)	.89
Use of anti-inflammatory medications, n (%)	28 (16.4)	21 (18.1)	7 (12.7)	.38
Family history of kidney disease, n (%)	26 (15.2)	16 (13.8)	10 (18.2)	.46

Missing data related to self-reported obesity in 2 cases.

The Prevalence of Decreased eGFR

During the event, the CKD-EPI 2009 equation was used to estimate GFR and to identify participants with decreased (<60 mL/min/1.73 m²) values. Seven participants (4.1%) were found and referred to a general practitioner for further evaluation. Figure 1 shows the distribution of eGFR according to gender and age. All participants who were less than 40 years old had eGFR above 60 mL/min/1.73 m².

Figure 1.

Distribution of eGFR (CKD-EPI 2009) according to gender and age.

However, after the event, we decided to test the agreement between alternative methods of eGFR calculation. The highest number of participants with a decreased eGFR was identified with the EKFC equation (10 [5.8%]), whereas the lowest was with the CKD-EPI 2021 equation (5 [2.9%]). The agreement in classification between equations is summarized in Table 2. The lowest agreement was found between EKFC and CKD-EPI 2021 (kappa = 0.653), while the highest was between the versions of the CKD-EPI equation (kappa = 0.827).

Table 2.

Agreement Between 3 eGFR Equations in the Identification of Decreased eGFR.

Estimated glomerular filtration rate classification			No of participants
EKFC	CKD-EPI 2009	CKD-EPI 2021	No of participants
Normal eGFR	Normal eGFR	Normal eGFR	161
Decreased eGFR	Normal eGFR	Normal eGFR	3
Decreased eGFR	Decreased eGFR	Normal eGFR	2
Decreased eGFR	Decreased eGFR	Decreased eGFR	5

All 3 participants identified with EKFC, but missed with other eGFR equations, were women of 75 or 77 years, with creatinine levels equal to 0.85 to 0.93 mg/dL. On the other hand, 2 patients who were identified with CKD-EPI 2009 but not with the 2021 formula, were a 40-year-old woman with creatinine 1.34 mg/dL, and a 57-year-old man with creatinine of 1.35 mg/dL.

Discrepancy Between Self-Reported Obesity and Calculated BMI

During the event, data on height and weight, as well as subjective classification of obesity, were collected. Out of 171 study participants, 86 (including 55 women) provided height and weight data necessary to calculate BMI (Supplementary materials, Table S3).

Men differed significantly from women in terms of average weight (t = −4.86, P < .001) and average height (t = −7.11, P < .001), whereas the difference in average BMI was not statistically significant (t = −1.22, P = 0.23).

In this study, 8 individuals (9.3%) did not consider themselves obese despite having a BMI in the obese range (underestimation), while 6 individuals (7.0%) perceived themselves as obese despite not meeting the BMI criteria (overestimation). Agreement between self-reported obesity and BMI-based classification was observed in 72 (83.7%) participants (Cohen’s kappa = 0.40). Full data are presented in Table 3.

Table 3.

Body Mass Classification Based on the Body Mass Index and Self-assessment.

Classification	Women	Men	No of participants
Based on BMI
Normal weight	26	15	41
Obesity	7	7	14
Overweight	20	10	30
Self-report
Normal weight	93	43	136
Obesity	13	18	31

To explore discrepancies between self-perceived obesity and BMI-based classifications, we examined mismatches across gender. Among women (n = 53), 7.5% underestimated their weight status (i.e., reported not being obese despite a BMI in the obesity range), while 3.8% overestimated it. In contrast, among men (n = 32), both underestimation and overestimation rates were 12.5%. A chi-square test revealed that these differences were not statistically significant for either underestimation (χ²(1) = 0.14, P = 0.71) or overestimation (χ²(1) = 1.18, P = 0.28). These results indicate that while misclassification of obesity is present in both genders, the likelihood of misperception does not significantly differ between men and women in this sample.

Logistic regression models were conducted to examine the associations between both self-reported obesity and obesity based on BMI with self-reported diabetes and hypertension. Self-reported obesity was significantly associated with an increased likelihood of diabetes (OR = 3.82, 95% CI: 1.39-10.48, p = .009) and hypertension (OR = 3.41, 95% CI: 1.53-7.58, P = .003). These results suggest that individuals who perceive themselves as obese are more likely to report cardiometabolic conditions, regardless of objective measurements.

In addition, obesity classified according to BMI was also significantly associated with diabetes (OR = 6.09, 95% CI: 1.33-28.01, P = .020), indicating an even stronger relationship than in the self-reported case. However, the association between BMI-defined obesity and hypertension was not statistically significant (OR = 1.48, 95% CI: 0.47-4.68, P = 0.50), suggesting potential discrepancies between objective and subjective indicators in predicting blood pressure conditions.

The Convenience of the Use of Nova Max Pro Creatinine and eGFR Meter

To our knowledge, the WKD event in Gdańsk was the first implementation of point-of-care (POC) creatinine screening in a community-led health event. Therefore, we aimed to receive feedback from the device users. After the study, all volunteers who performed POC creatinine measurements (n = 6), including medical students and 1 internal medicine specialist, rated the device as “very easy” to use.

Discussion

Chronic kidney disease (CKD) is a common public health issue. Early detection enables timely interventions that can slow the progression of disease.¹⁸ Renal replacement therapy (RRT) is one of the most expensive therapies. In Poland, according to the National RRT Registry, approximately 20 thousand patients are treated utilizing dialysis, and more than 16 000 are after kidney transplant.¹⁹

Given the frequent absence of symptoms in the early stages of CKD, screening strategies are important. POC creatinine testing was used for kidney disease detection in high-risk populations with limited healthcare access, such as agricultural communities in Nicaragua and Guatemala.^20,21 Moreover, POC creatinine testing was implemented in diverse clinical contexts, including rapid kidney function assessment in radiology outpatients receiving iodinated contrast agents (to prevent contrast-induced nephropathy),²² exclusion of kidney failure for optimized drug dosing,²³ and community pharmacy-based CKD screening programs.²⁴

In a Dutch study by Heringa et al,²³ 351 community pharmacies used the StatSensor Creatinine Xpress-meter to increase antibiotic safety in elderly patients. POC testing was performed in selected individuals, with 1852 eGFR measurements documented. Impaired renal function was defined as an eGFR of ≤50 mL/min/1.73 m². The prevalence of impaired kidney function increased with age: 6.1% in patients <80 years, 11.6% in those aged 80 to 89 years, and 29.2% in patients ≥90 years.

Similarly, Papastergiou et al. described a CKD screening program across 4 community pharmacies in British Columbia, Canada, involving 642 high-risk participants (mean age: 60 years; 55% female) with at least 1 CKD risk factor. Pharmacists measured creatinine in capillary blood using the Piccolo Xpress® Comprehensive Metabolic Panel and calculated eGFR using the CKD-EPI 2009 formula. Results revealed 11.5% of participants had eGFR <60 mL/min/1.73 m². Pharmacists also checked blood pressure (98%) and educated patients (89%).²⁴ For comparison, in the current study, decreased eGFR was identified in 4.1% (CKD-EPI 2009), 2.9% (CKD-EPI 2021), or 5.8% (EKFC), but one must note that the sample was not predetermined (i.e., elderly or other high-risk patients).

To our knowledge, the WKD event in Gdańsk is the first implementation of POC creatinine screening in a community-led health event. Prior studies focused on pharmacy-based, occupational, or clinical settings. Our findings demonstrate POC creatinine testing can be successfully integrated into such events.²²

Our study revealed that people at risk of CKD may not be aware of their risk factors. Nearly 1 in 10 obese people was unaware of their obesity. In another study from Poland, 21.2% of overweight or obese people were unaware of being overweight and obese; it was more common among men.²⁵ Therefore, we encourage future organizers of WKD to measure body mass, calculate BMI, and—in case of values ≥30 kg/m²—inform participants about obesity diagnosis, optimal body weight, and treatment options. Another potentially underdiagnosed risk factor is hypertension. Studies from Poland suggest that approximately 40.7% of individuals with elevated blood pressure may be unaware of their condition.²⁶ While our single measurement cannot establish a diagnosis of hypertension, which usually requires multiple readings on separate occasions, it serves as an important screening tool to identify individuals who require further medical evaluation.

Taking all into consideration, identifying patients unaware of their comorbidities (not only single risk factors such as hypertension or obesity, but also their complex presence, e.g., accompanied by diabetes, as it corresponds to decreased eGFR) is an important element of kidney health awareness and screening initiatives. Furthermore, screening for CKD risk factors before the POC creatinine level testing might be a cost-effective solution.

Strengths and Innovations of our Approach

Our WKD initiative in Gdańsk demonstrated several key strengths that contributed to its success. The implementation of rapid, minimally invasive creatinine measurements represented a significant advancement in community-based kidney health screening. Using only 1.2 µL of capillary blood, with results within 1 min, made the process efficient and acceptable in a non-clinical environment. The use of disposable paper tablecloths for quick biohazard management improves the safety of the event.

The careful planning of blood pressure measurements, including adequate seated rest time before measurement, helped ensure accurate readings—especially important in public settings where participants may have been physically active prior to testing.

The collaboration between the Medical University of Gdańsk and the University of Gdańsk created a robust interdisciplinary framework, combining medical expertise with community engagement skills to enhance both clinical validity and educational value. The strategic choice of Madison Shopping Center as the venue effectively reached diverse demographics, particularly middle-aged and elderly individuals at higher risk for kidney disease, including those who might not regularly engage with healthcare services.

Our innovative use of QR codes linking to nutritional resources and urine test interpretation guides extended educational impact beyond the event. Using the accessible, already existing national nutritional resources¹⁵ for dietary education enhances their impact on the community, increases their visibility, and is a cost-efficient solution. The dietary advice is beneficial for all patients, not only those already affected by obesity.²⁷ Therefore, increasing the visibility of the free, state-funded nutritional resources is crucial for public health.

The decision to use the CKD-EPI 2009 formula for GFR estimation was appropriate given its established validity and our subsequent comparative analysis. Recent comprehensive studies, including the multicenter evaluation by Delanaye et al., have demonstrated that the newer 2021 race-agnostic CKD-EPI equation performs suboptimally in European populations, with a substantial overestimation of GFR in White Europeans when compared with the 2009 equation.²⁸ Furthermore, the implementation of the CKD-EPI 2021 equation would reduce CKD (stages G3a-G5) prevalence by approximately 25%, potentially missing high-risk patients who might benefit from early interventions.²⁹ In our study, comparative analysis between both equations confirmed these findings, with the 2009 formula (without race coefficient, as is standard practice in Europe) found more cases of impaired kidney function than the 2021 formula. Further studies are needed to establish the value of other equations, including highly promising EKFC,²⁸ in population screening.

Efficient workflow organization—having participants complete questionnaires with volunteer assistance while waiting—maximized resources and addressed practical barriers such as forgotten reading glasses. Comprehensive promotion through multiple channels (including social media, posters, local news, and radio) further contributed to the event’s success.

Limitations and Future Directions

While our initiative demonstrated several strengths, certain limitations should be acknowledged. For instance, single measurements of blood pressure and creatinine, while valuable for screening purposes, cannot establish definitive diagnoses. Furthermore, while public screening initiatives serve an educational purpose and might facilitate the identification of previously undiagnosed individuals, from a broader public health and systemic perspective, their cost-effectiveness may be limited, for example, due to relatively low participation rates and the number of newly identified cases. Therefore, the initiative’s major impact was educational, increasing public awareness of kidney disease and its risk factors. However, as the present study was not designed to evaluate cost-effectiveness, this aspect remains an important topic for future research aimed at informing public health policy and efficient resource allocation. Overall, the educational effects of public screening initiatives, although difficult to quantify in the short term, may contribute indirectly to earlier health-seeking behaviors and improved disease prevention.

Several operational challenges were also identified. We relied on self-reported weight data, which may have reduced accuracy as some participants were uncertain of their current weight. The reliance on QR codes for educational materials, while innovative, created access barriers for elderly participants and those with limited technological literacy. Self-reported information regarding recent food intake—which can affect both glucose and creatinine levels—was difficult to verify, potentially impacting the interpretation of results. Additionally, the usability assessment of the Nova Max Pro device was limited to only 6 users, primarily consisting of medical students, which may not be representative of the broader population of potential organizers for similar community health initiatives.

Such an event is also a great opportunity to promote general health awareness and, more specifically in this context, to educate people about the correct technique for measuring blood pressure. In implementing proper measurement procedures, we followed the 2024 ESC Guidelines.¹⁶ While it is recommended to take 2 measurements approximately 1 min apart (and a third, if the difference between the 2 readings exceeds 10 mmHg), due to time constraints and the limited number of available workstations, we were unable to perform multiple blood pressure measurements on both arms. Additionally, in order to optimize future community-based kidney health screening initiatives, based on the implementation experience of our action, we suggest putting into practice the project-based recommendations.

Recommendations for Future Community-Based Kidney Health Screening Initiatives

Based on the implementation process of the project, for future WKD events, we recommend:

Expanding screening to additional locations to reach more diverse populations, including rural communities and those with lower socioeconomic status who may have limited access to healthcare. Since women appear more likely to participate voluntarily in health screening events, targeted outreach strategies should be developed to actively encourage male participation, particularly among those aged 40 and above. Given that no participants under 40 years had decreased eGFR, screening efforts may be most cost-effective when focused on middle-aged and older populations.

Implementing weight and height measurements with appropriate privacy considerations and facilities for removing outerwear, as accurate BMI calculation is important for assessing obesity as a risk factor. It may incorporate waist circumference measurements alongside BMI to better assess metabolic risk.

Complementing digital resources with traditional printed materials (informational leaflets, brochures) to ensure accessibility for all age groups and technological backgrounds.

Reorganizing testing stations to increase the number of blood pressure measurement points, as this procedure proved to be the most time-consuming element of the screening process. Moreover, the increased number of blood pressure measurement stations would allow for multiple measurements (2 times for each arm) as recommended in the current guidelines.

Developing personalized feedback forms that would provide tailored recommendations based on individual risk factor profiles, enhancing the educational impact of the screening.

Providing drinking water at the event for both participant comfort and education about the importance of water intake.

Developing a standardized protocol for training volunteers to ensure consistency in future community-based screening events.

Establishing follow-up mechanisms to determine whether participants identified as being at risk sought appropriate medical care.

Conclusion

Community-based CKD screening and education using a collaborative academic model proves feasible and effective for early detection initiatives. The substantial variation in detection rates between eGFR formulas necessitates careful equation selection, with CKD-EPI 2009 remaining optimal for European populations.

Self-assessment proves unreliable for identifying obesity as a CKD risk factor, requiring objective measurements in screening protocols. Point-of-care creatinine testing demonstrates high usability for non-clinical community settings.

The WKD event in Gdańsk successfully combined assessment of self-reported CKD risk factors with objective measurements of blood pressure and creatinine levels, identifying individuals with potentially decreased kidney function who may benefit from further medical evaluation.

The collaborative approach between academic institutions, strategic venue selection, and innovative educational tools contributed to this public health initiative’s success.

Such community screening events complement traditional healthcare services and play an important role in early CKD detection, particularly among individuals who may be unaware of their risk factors. Future initiatives should prioritize demographic diversification, standardized anthropometric measurements, enhanced operational capacity, and multi-modal educational approaches to optimize early CKD detection and prevention efforts.

Supplemental Material

sj-docx-1-jpc-10.1177_21501319261422888 – Supplemental material for World Kidney Day 2025 in Gdańsk: Results and Insights From Community-Based Screening for Kidney Diseases and Their Risk Factors

Supplemental material, sj-docx-1-jpc-10.1177_21501319261422888 for World Kidney Day 2025 in Gdańsk: Results and Insights From Community-Based Screening for Kidney Diseases and Their Risk Factors by Jakub Ruszkowski, Judyta Borchet, Damian Stencelewski, Piotr Kapiszka, Daria Urban, Maciej Pancewicz, Agata Błach, Aleksandra Mańkowska and Alicja Dębska-Ślizień in Journal of Primary Care & Community Health

Footnotes

Acknowledgements

The authors gratefully acknowledge Nova Biomedical for providing the Nova Max Pro Creatinine and eGFR Meter free of charge and Madison Shopping Center in Gdańsk for the complimentary venue space, which were essential to the success of this World Kidney Day initiative. We also thank all volunteers from both universities and the participants who contributed to this study.

ORCID iDs

Jakub Ruszkowski

Judyta Borchet

Alicja Dębska-Ślizień

Ethical Considerations

This study presents a retrospective analysis of basic data collected during a voluntary community health screening initiative conducted as part of World Kidney Day 2025. The screening campaign itself was a standard public health promotion activity that did not require formal ethics committee approval due to its community health promotion nature and the minimal risk procedures involved (confirmed retrospectively by Bioethics Committee for Scientific Research of the Medical University of Gdańsk on 30^th of December 2025). All participants volunteered and were informed about the nature and purpose of the screening activity. Verbal informed consent was obtained prior to participation. No sensitive personal data were collected, and no biological samples were stored beyond immediate screening. Given that the original activity was a routine community screening and the current analysis involves only basic, de-identified data, formal ethics committee approval was not required. The campaign and subsequent analysis were conducted in accordance with ethical standards applicable to public health initiatives.

Consent to Participate

All study participants provided informed consent to participate in the study.

Author Contributions

Conceptualization: Jakub Ruszkowski, Judyta Borchet. Formal analysis: Jakub Ruszkowski, Judyta Borchet, Aleksandra Mańkowska. Investigation: Jakub Ruszkowski, Judyta Borchet, Damian Stencelewski, Piotr Kapiszka, Daria Urban, Maciej Pancewicz, Agata Błach. Writing – Original Draft: Jakub Ruszkowski, Judyta Borchet, Damian Stencelewski, Piotr Kapiszka, Daria Urban, Maciej Pancewicz, Agata Błach, Aleksandra Mańkowska. Writing – Review & Editing: Jakub Ruszkowski, Judyta Borchet, Alicja Dębska-Ślizień. Visualization: Jakub Ruszkowski. Funding acquisition: Alicja Dębska-Ślizień.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The cost of the publication was covered by the Medical University of Gdańsk (01-10026/0010407).

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Data Availability Statement

Data available upon request.

Supplemental Material

Supplemental material for this article is available online.

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