Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ KIDNEY DISEASE, CHRONIC (CKD) +++ Population ++ – Adults. +++ Recommendations +++ USPSTF 2012 ++ – Insufficient evidence to recommend for or against routine screening. +++ Source ++ – USPSTF. Chronic Kidney Disease (CKD): Screening. 2012. +++ ACP 2013, AAFP 2014 ++ – Do not screen adults unless they have symptoms or risk factors. – Adults taking an ACE inhibitor or ARB should not be tested for proteinuria, regardless of diabetes status. +++ Sources ++ – AAFP. Clinical Recommendations: Chronic Kidney Disease. 2014. – Ann Intern Med. 2013;159(12):835. +++ NICE 2014 ++ – Monitor glomerular filtration rate (GFR) at least annually in people who are prescribed drugs known to be nephrotoxic.a – Screen renal function in people at risk for CKD.b +++ Source ++ – NICE. Early Identification and Management of Chronic Kidney Disease in Adults in Primary and Secondary Care. London (UK): NICE; 2014. +++ VA/DoD 2019 ++ – For patients at risk for CKD (DM, HTN, cardiac disease/CHF, or vascular disease), systemic illness such as HIV, urinary tract abnormalities, history of AKI, proteinuria, family history of kidney disease, age >60 y, and ethnicities associated with increased risk (eg, African-Americans, Hispanics, Native Americans), periodically obtain SCr, eGFR, urinalysis, and spot uACR. Periodicity of screening is not defined. +++ Comments ++ Diagnose CKD if either of the following present for >3 months: Markers of kidney damage such as albuminuria >30 mg/g, urinary sediment abnormalities, electrolyte abnormalities due to tubular disorders, histologic abnormalities, structural abnormalities by imaging, or kidney transplantation. GFR <60 mL/min/1.73 m2. +++ Source ++ – Kidney Disease Improving Global Outcomes (KDIGO). KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease 2013;3(1). + ++ aExamples: calcineurin inhibitors, lithium, or nonsteroidal anti-inflammatory drugs (NSAIDs). ++ bDM, HTN, CVD, structural renal disease, nephrolithiasis, benign prostatic hyperplasia (BPH), multisystem diseases with potential kidney involvement (eg, systemic lupus erythematosus [SLE]), FH of stage 5 CKD or hereditary kidney disease, or personal history of hematuria or proteinuria. Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth