Screening for chronic kidney disease
- Gregorio T Obrador, MD, MPH
Gregorio T Obrador, MD, MPH
- Adjunct Assistant Professor of Medicine
- Tufts University School of Medicine
- Dean and Professor of Medicine
- Universidad Panamericana School of Medicine
- Marcello Tonelli, MD, SM, FRCPC
Marcello Tonelli, MD, SM, FRCPC
- Associate Vice President (Health Research), University of Calgary
- Senior Associate Dean (Clinical Research), Cumming School of Medicine
- Professor of Medicine, University of Calgary
Chronic kidney disease (CKD) is a worldwide public health problem. In the United States, the prevalence of end-stage renal disease (ESRD) is increasing [1,2]. Patients with ESRD consume a disproportionate share of healthcare resources [2-4] and experience significant mortality and morbidity and a reduced quality of life [3,5,6].
The identification and management of patients who have early stages of CKD may slow or prevent the progression to ESRD [7,8].
This topic reviews recommendations for population-based CKD screening and case finding. Overviews of the epidemiology and management of CKD and its complications are discussed elsewhere. (See "Epidemiology of chronic kidney disease" and "Overview of the management of chronic kidney disease in adults".)
RATIONALE FOR SCREENING
The rationale for screening for CKD is that earlier detection of CKD allows for the implementation of therapeutic interventions and avoidance of inappropriate exposure to nephrotoxic agents, both which may slow the progression of CKD to end-stage renal disease (ESRD) [7,8]. The detection of CKD also identifies an important risk factor for cardiovascular disease (CVD). (See "Coronary heart disease and myocardial infarction in young men and women", section on 'Coronary risk factors' and "Prevalence of and risk factors for coronary heart disease in diabetes mellitus".)
Early detection of CKD with reduced glomerular filtration rate (GFR) may also facilitate appropriate dosing of medications and allow timely preparation for renal replacement, which may improve outcome . (See "Overview of the management of chronic kidney disease in adults", section on 'Consequences of late referral'.)
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