According to the Centers for Disease Control & Prevention, 37 million American adults are estimated to have chronic kidney disease (CKD), with 90% unaware of the condition.
Risk factors for kidney disease include diabetes, high blood pressure, heart disease, obesity, history of acute kidney injury, and family history. CKD puts patients at increased risk for cardiovascular events and progression to kidney failure and death. By screening high risk populations for CKD, primary care providers are poised to slow CKD progression and reduce end stage kidney disease.
The National Committee for Quality Assurance (NCQA) recognizes the importance of this screening through the HEDIS measure “Kidney Health Evaluation for Patients with Diabetes,” which tracks the rate of annual screening in adults with type 1 or 2 diabetes. Early detection of CKD offers an opportunity to prevent complications before symptoms occur and to slow loss of kidney function over time.
CKD is diagnosed by two widely available and inexpensive tests:
- estimated glomerular filtration rate (eGFR)
- urine albumin-creatinine ratio (uACR)
The eGFR and uACR tests are independent and complementary predictors of important clinical outcomes including CKD progression, end-stage renal disease, cardiovascular mortality, and all-cause mortality. Both tests are important as albuminuria is often detected before the eGFR drops below 60 mL/min/1.73 m2, thus allowing earlier CKD diagnosis and intervention.
However, uACR testing in people at risk for CKD remains underutilized. The heat map included here simplifies staging of CKD based on these two tests. For tips on communicating CKD test results and explaining a heat map to patients, view this helpful document from the National Kidney Foundation.
When CKD is diagnosed early, primary care physicians are more likely to prescribe ACE inhibitors or Angiotensin Receptor Blockers when indicated, and to refer patients to a nephrologist when appropriate.
Source: National Kidney Foundation of Michigan (NKFM)
|