Population-based screening for nephrosis, nephritis and renal stone in Thailand
Patsri Srisuwan*, Tanunya Koopitakkajorn†, Det Kedcham‡, Pritaporn Kingkaew†, Sitaporn Youngkong†,
Sripen Tantivess†, and Yot Teerawattananon†
*Outpatient and Family Medicine Department, Phramongkutklao Hospital, †Health Intervention and Technology
Assessment Program, Ministry of Public Health, ‡ASEAN Institute for Health Development, Mahidol University
Nephrosis, nephritis and renal stone, commonly found diseases in Thailand, can cause severe chronic
complications. This article thus aims to study the value of a population-based screening for nephrosis,
nephritis and renal stone in Thailand through a systematic literature review and stakeholder discussion.
Urinalysis and blood for renal function tests are widely used in health check-up programs without evidence
of effectiveness and cost-effectiveness. Analysis of the clinical practice guidelines and experts’ opinions
found support for screening in high-risk groups, but not in the general population. Cost-effectiveness
ratio was $282,818 per quality-adjusted life year (QALY), but $53,372 and $18,621 per QALY, in the elderly
and hypertensive patients, respectively. One case would be diagnosed per 800 screened. Incremental costeffectiveness
ratio was $2779. Therefore, renal function tests or urinalysis are recommended for high-risk
groups, whereas the general population should be educated on the disease and risk reduction. Further
studies of the effective and appropriate screening tests for high-risk groups are also needed.