Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + KIDNEY DISEASE, CHRONIC (CKD) Download Section PDF Listen +++ +++ Population ++ Adults. +++ Recommendations +++ USPSTF 2012 ++ Insufficient evidence to recommend for or against routine screening. +++ Source ++ USPSTF. Chronic Kidney Disease (CKD): Screening. 2012. +++ ACP 2013, AAFP 2014 ++ Do not screen adults unless they have symptoms or risk factors. Adults taking an ACE inhibitor or ARB should not be tested for proteinuria, regardless of diabetes status. +++ Sources ++ AAFP. Clinical Recommendations: Chronic Kidney Disease. 2014. Ann Intern Med. 2013;159(12):835. +++ NICE 2014 ++ Monitor glomerular filtration rate (GFR) at least annually in people who are prescribed drugs known to be nephrotoxic.a Screen renal function in people at risk for CKD.b +++ Source ++ NICE. Early Identification and Management of Chronic Kidney Disease in Adults in Primary and Secondary Care. London (UK): NICE; 2014. +++ Comments ++ Diagnose CKD if either of the following present for >3 months: Markers of kidney damage such as albuminuria >30 mg/g, urinary sediment abnormalities, electrolyte abnormalities due to tubular disorders, histologic abnormalities, structural abnormalities by imaging, or kidney transplantation. GFR <60 mL/min/1.73 m2. +++ Source ++ Kidney Disease Improving Global Outcomes (KDIGO). KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease 2013;3(1). + ++ aExamples: calcineurin inhibitors, lithium, or nonsteroidal anti-inflammatory drugs (NSAIDs). ++ bDM, HTN, CVD, structural renal disease, nephrolithiasis, benign prostatic hyperplasia (BPH), multisystem diseases with potential kidney involvement (eg, systemic lupus erythematosus [SLE]), FH of stage 5 CKD or hereditary kidney disease, or personal history of hematuria or proteinuria.