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

Sponsoring Organizations

American Society for Clinical Pathology

Sources

Expert consensus

Disciplines

Nephrologic

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.
https://www.ascp.org/content/docs/default-source/get-involved-pdfs/istp-ckd/ckd-practice-algorithm.pdf