Chronic kidney disease (CKD) is a major health concern, increasing risks for mortality, cardiovascular issues, and kidney failure. Early identification and management are key to reducing these risks. A 5-step plan for CKD evaluation includes recognizing criteria such as abnormal kidney structure or function lasting more than three months, screening with tests like albumin-to-creatinine ratio (ACR) and glomerular filtration rate (GFR) and implementing an action plan based on CKD classification. Referrals to a nephrologist are recommended when GFR drops below 30 mL/min/1.73m2 or ACR exceeds 300 mg/g.

GFR is the most accurate method for assessing kidney function, but it’s usually estimated using equations involving serum creatinine, age, race, and gender. A reduced GFR, particularly below 60 mL/min/1.73m2, increases the risk of complications, including cardiovascular disease. Albuminuria, detected via spot urine ACR, is a key marker for kidney damage. Persistent elevated albumin levels over three months signal kidney dysfunction. Monitoring GFR and ACR over time is crucial for managing CKD and preventing progression to more severe stages such as end-stage renal disease.

Reference: Quick Reference Guide on Kidney Disease Screening. National Kidney Foundation. Accessed February 26, 2025. https://www.kidney.org/quick-reference-guide-kidney-disease-screening