Don’t request just a serum creatinine to test adult patients with diabetes and/or hypertension for chronic kidney disease; use the kidney profile (serum creatinine with eGFR and urinary albumin-creatinine ratio.)
|Rationale and Comments:||Use the National Kidney Foundation updated evidence-based kidney profile test to evaluate patients for chronic kidney disease with the following common tests to more effectively assess kidney function. “Spot” urine for albumin-creatinine ratio to detect albuminuria Serum creatinine to estimate glomerular filtration rate using the Chronic Kidney Disease Epidemiology Collaboration equation|
|References:||• KDOQI US Commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. Am J Kidney Dis. 2014;63:713-735.
• American Diabetes Association. 10. Microvascular Complications and Foot Care: Standards of Medical Care in Diabetes—2018. Diabetes Care. 2018;41(Suppl 1):S28-S37.
• Vassalotti JA, Centor R, Turner BJ, et al. A practical approach to detection and management of chronic kidney disease for the primary care clinician. Am J Med. 2015;129:153-162.
• Berns JS. Routine screening for CKD should be done in asymptomatic adults….selectively. Clin J Am Soc Nephrol. 2014;9:1988-1992.
• Matsushita K, et al. Clinical risk implications of the CKD Epidemiology Collaboration (CKD-EPI) equation compared with the Modification of Diet in Renal Disease (MDRD) Study equation for estimated GFR. Am J Kidney Dis. 2010;60(2):241-249.