Screening

Your Organisational Guidance

ebpracticenet urges you to prioritise the following organisational guidance:

Chronisch nierlijden (multidisciplinaire aanpak)Published by: WORELLast published: 2017GPC pluridisciplinaire sur la néphropathie chronique (IRC)Published by: Groupe de travail Développement de recommandations de première ligneLast published: 2017

There are no established screening guidelines for the general population for CKD; screening for CKD is controversial. However, early identification of CKD in people at risk is likely to be beneficial if it is combined with risk stratification and treatment to delay progression and reduce cardiovascular risk.[59][60]

Based on expert consensus emerging from a Kidney Disease: Improving Global Outcomes (KDIGO) controversies conference, the following recommendations were developed for CKD screening and risk stratification for people considered high-risk:[59]

  • Screening is recommended in people with hypertension, diabetes, or cardiovascular disease.

  • Screening should be considered for people with other risk factors (e.g., older age, high-risk race/ethnicity, systemic diseases that impact kidneys, family history of kidney disease, genetic risk factors, poor access to health care or low socioeconomic status, high-risk occupations and environmental exposures, prior acute kidney injury, preeclampsia, exposure to nephrotoxins, and obesity).

  • Decisions about starting and frequency of CKD screening should be individualised based on kidney and cardiovascular risk profiles and individual preferences.

  • Screening should include estimated glomerular filtration rate (eGFR; creatinine and cystatin C, if available) and measurement of albuminuria (urine albumin-to-creatinine ratio).

The American Diabetes Association recommends assessing eGFR and albuminuria at least annually in people with type 1 diabetes of ≥5 years duration and all people with type 2 diabetes regardless of treatment.[61]

​The UK National Institute for Health and Care Excellence (NICE) recommends annual monitoring for patients taking drugs that can adversely affect kidney function (e.g., calcineurin inhibitors, lithium, chronic use of nonsteroidal anti-inflammatory drugs [NSAIDs]).[50]

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