Screening for Chronic Kidney Disease
Chronic kidney disease is defined by the presence of a low GFR (<60 ml/min) and/or evidence of kidney damage (e.g. proteinuria, haematuria, imaging abnormalities) for more than 3 months. Individuals at increased risk for chronic kidney disease should be screened annually. These include individuals with the following: Diabetes mellitus HIV infection Hypertension Cardiovascular, cerebrovascular
Chronic kidney disease is defined by the presence of a low GFR (<60 ml/min) and/or evidence of kidney damage (e.g. proteinuria, haematuria, imaging abnormalities) for more than 3 months. Individuals at increased risk for chronic kidney disease should be screened annually. These include individuals with the following:
- Diabetes mellitus
- HIV infection
- Hypertension
- Cardiovascular, cerebrovascular or peripheral vascular disease
- Obesity
- Autoimmune diseases
- Prior acute kidney injury
- Prior pre-eclampsia or eclampsia or HELLP syndrome
- Age >60 years
- Family history of kidney disease
Note 1:
Screening should involve blood pressure and blood glucose measurement, urine dipstick testing and estimation of GFR. If proteinuria is found on dipstick testing then protein excretion should be quantified by measuring the protein/creatinine ratio or albumin/creatinine ratio on a random urine sample. The preferred method of estimating GFR is the CKD-EPI equation.
Note 2:
Once a diagnosis of CKD is made, renal function should be monitored more frequently, especially in patients with:
- GFR <60 ml/min/1.73 m2
- Rapid GFR decline
- Risk factors for rapid GFR decline e.g. use of NSAIDs
Paget G, Naicker S, et al. Guideline for the optimal care of patients on chronic dialysis in South Africa. South African Renal Society; 2015.