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Asian chronic kidney disease best practice recommendations: Positional statements for early detection of chronic kidney disease from Asian Forum for Chronic Kidney Disease Initiatives (AFCKDI)

Authors


  • Declaration of interests: All members of the Work Group were asked to submit a written record of possible conflicts of interest related to the screening of chronic kidney disease. No other conflicts of interest were declared.

Professor Philip KT Li, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China. Email: philipli@cuhk.edu.hk

AFCKDI RECOMMENDATIONS FOR EARLY DETECTION OF CHRONIC KIDNEY DISEASE

1. Targets

Patients with diabetes, hypertension

Those with family history of chronic kidney disease (CKD)

Individuals receiving potentially nephrotoxic drugs, herbs or substances or taking indigenous medicine

Patients with past history of acute kidney injury

Individuals older than 65 years

2. Tools

Spot urine sample for protein with standard urine Dipstick test (need a repeat confirmatory test if positive)

Dipstick for red blood cells (need confirmation by urine microscopy)

An estimate of glomerular filtration rate based on serum creatinine concentration

3. Frequency of screening

Screening frequency for targeted individuals should be yearly if no abnormality is detected on initial evaluation.

4. Who should perform the screening

Doctors, nurses, paramedical staff and other trained healthcare professionals

5. Intervention after screening

Patients detected to have CKD should be referred to primary care physicians with experience in management of kidney disease for follow up. A management protocol should be provided to the primary care physicians. Further referral to nephrologists for management will be based on the protocol together with clinical judgment of the primary care physicians with their assessment of the severity of CKD and the likelihood of progression.

6. Screening for cardiovascular disease risk

It is recommended that cardiovascular disease risk factors should be screened in all patients with CKD.

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