Testing for CKD should not be universal, but should be targeted for individuals at increased risk of developing CKD:
ACR (mg/mmol) |
PCR (mg/mmol) |
Urinary protein excretion (g/24h) |
---|---|---|
30 | 50 | 0.5 |
60 | 100 | 1 |
In patients with a new finding of reduced eGFR, retest eGFR to exclude causes of acute deterioration of eGFR (e.g. acute kidney injury, or initiation of ACEi or ARB therapy).
In patients with a previous finding of an abnormal eGFR and ACR in the past 6 months, you do not have re-test.
Albuminuria (ACR) Categories | |||||
A1 | A2 | A3 | |||
<3 mg/mmol | 3-30 mg/mmol | >30 mg/mmol | |||
eGFR Categories |
G1 | ≥90 | |||
G2 | 60-89 | ||||
G3a | 45-59 | ||||
G3b | 30-44 | ||||
G4 | 15-29 | ||||
G5 | <15 |
Low risk |
|||
Moderate risk Test annually |
Very High risk Test 3 times per year |
||
High risk Test 2 times per year |
Very high risk Test 4+ times per year |
In patients with a new finding of reduced eGFR, retest eGFR to exclude causes of acute deterioration of eGFR (e.g. acute kidney injury, or initiation of ACEi or ARB therapy).
In patients with a previous finding of an abnormal eGFR and ACR in the past 6 months, you do not have re-test.
Albuminuria (ACR) Categories | |||||
A1 | A2 | A3 | |||
<3 mg/mmol | 3-30 mg/mmol | >30 mg/mmol | |||
eGFR Categories |
G1 | ≥90 | |||
G2 | 60-89 | ||||
G3a | 45-59 | ||||
G3b | 30-44 | ||||
G4 | 15-29 | ||||
G5 | <15 |
Low risk |
|||
Moderate risk Test annually |
Very High risk Test 3 times per year |
||
High risk Test 2 times per year |
Very high risk Test 4+ times per year |
Persistent hematuria | Action |
---|---|
To confirm persistent hematuria from transient hematuria | Requires 2 out of 3 positive reagent strips |
With or without proteinuria | Investigate for urinary tract malignancy in appropriate age groups |
With ACR >3 mg/mmol | Refer to nephrologist |
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