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Below is a summary from the International Society of Nephrology (ISN) Kidney Hypertension Diabetes Control (KHDC) guidelines for screening people at risk for CKD.

CKD is defined by the presence of a GFR of less than 60 ml/min/1.73m2 and/or albuminuria present on repeated testing.

Data from guidelines are also developed by the following sources:

• KDIGO
• The Kidney Disease Outcomes Quality Initiative (K/DOQI)
• The Caring for Australians with Renal Impairment (CARI)
• The European Best Practice Guidelines (EBPG)
• The United Kingdom Renal Association
• The Canadian Society of Nephrology

Urinalysis

Detection of urinary hemoglobin, glucose, leukocytes, nitrates and proteins will be done by dipstick (Multistix). Subjects with urine samples positive for leukocytes or nitrates, that may provide falsely elevated results with proteins, should be asked to repeat the analysis when urinary infections have been excluded.

Urine albumin or protein concentration

On the same spot urine sample, urine albumin or protein and/or creatinine may be determined either using reagent strips or quantitative methods according to the local facility available. Albuminuria is the preferred measurement to proteinuria, if feasible. If the first test is positive, a confirmative test for urine albumin or protein is recommended, when resources are available, to reduce the possibility of false positives. Increased excretion of urine albumin/protein is a sensitive marker of kidney damage.

The definition of albuminuria is an elevated ratio of albumin to creatinine (ACR) in an untimed urine sample as recommended by The National Kidney Foundation PARADE and The American Diabetes Association in the assessment of proteinuria in CKD. The following ACR categories in mg/g are: a) normal, <30mg/g; b) microalbuminuria, 30 ~ 299 mg/g; c) macroalbuminuria, >300 mg/g. Macroalbuminuria equates to 1+ proteinuria on a dipstick.

Serum creatinine and GFR

Blood samples will be collected to determine serum creatinine concentration, which is required to calculate the estimated GFR (eGFR). eGFR will be calculated automatically after input of data into the central electronic database. This database is not available in many laboratories in the world.

CKD is defined by the presence of a GFR of less than 60 ml/min/1.73m2 and/or albuminuria present on repeated testing.

For more information, please download the KHDC guidelines

Data from guidelines are also developed by the following sources: KDIGO, the Kidney Disease Outcomes Quality Initiative (K/DOQI); the Caring for Australians with Renal Impairment (CARI); the European Best Practice Guidelines (EBPG); the United Kingdom Renal Association; and the Canadian Society of Nephrology.