Chronic Kidney Disease (CKD) is:
- The persistent and usually progressive reduction in glomerular filtration rate (GFR less than 60 mL/min/1.73 m2), and/or
- Albuminuria (more than 30 mg of urinary albumin per gram of urinary creatinine).
Simple Testing Is Needed To Detect Early CKD
Test adults with:
- Diabetes once per year.
- Hypertension at diagnosis and initiation of therapy-then, if normal, every 3 years.*
- A family history of kidney failure every 3 years as long as the tests remain normal.*
* This testing interval is opinion based. Use your discretion.
Use these independent tests to detect CKD:
- Serum creatinine applied to a prediction equation to estimate GFR is preferable to a 24-hour urine collection (see GFR Calculator below).
- A spot urine albumin to urine creatinine ratio is preferable to 24-hour urine collection for albumin excretion.
- Get blood pressure checked.
Use or download the GFR Calculator
- You will need to fill in the values below:
|Plasma creatinine (PCR) (mg/dl)
Prevention Is Possible and Early Treatment Can Slow Progression and Reduce Cardiovascular Risk
For patients with a family history of CKD:
- Advise patients to take action to prevent hypertension and diabetes.
For patients with diabetes or hypertension and CKD:
- Prescribe angiotensin converting enzyme inhibitor or angiotensin receptor blocker to protect kidney function.
- A diuretic should usually be part of the hypertension regimen.
- Keep blood pressure below 130/80 mmHg.
It is also important to:
- Provide referral for dietary counseling. (Medicare will pay for nutrition counseling for CKD.)
- Advise tight glycemic control for patients with diabetes.
- Monitor and treat traditional cardiovascular risk factors, particularly smoking and hypercholesterolemia.
- Refer patients to a nephrologist for an early opinion.
- Provide ongoing primary care.
- Team with a nephrologist once the GFR is 30 mL/min/1.73 m2 or less.