CKD Quick Reference Card

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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:

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.