Chronic kidney disease in adults: assessment and management

National Institute for Health and Care Excellence


Investigations for chronic kidney disease

Who should be tested for CKD

  • Monitor GFR at least annually in people prescribed drugs known to be nephrotoxic, such as calcineurin inhibitors (for example, cyclosporin or tacrolimus), lithium and non-steroidal anti-inflammatory drugs (NSAIDs) 
  • Offer testing for CKD using eGFRcreatinine and ACR to people with any of the following risk factors:
    • diabetes
    • hypertension
    • acute kidney injury
    • cardiovascular disease (ischaemic heart disease, chronic heart failure, peripheral vascular disease or cerebral vascular disease)
    • structural renal tract disease, recurrent renal calculi or prostatic hypertrophy
    • multisystem diseases with potential kidney involvement – for example, systemic lupus erythematosus
    • opportunistic detection of haematuria
    • family history of end-stage kidney disease (GFR category G5) or hereditary kidney disease
  • Do not use age, gender or ethnicity as risk markers to test people for CKD. In the absence of metabolic syndrome, diabetes or hypertension, do not use obesity alone as a risk marker to test people for CKD

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