Advancing CKD and Cardiovascular Risk Management Through Diagnostic Testing - Episode 7
Evaluating Clinical Gaps in Combining uACR and eGFR Testing in CKD Diagnosis
Learn why pairing eGFR with urine albumin-creatinine ratio improves CKD screening, avoids missed diagnoses, and guides follow-up care.
This episode, titled, ‘Evaluating Clinical Gaps in Combining uACR and eGFR Testing in CKD Diagnosis,’ features panelists discussing the following critical questions:
- Do gaps persist in combining uACR and eGFR testing among patients with CKD-related comorbidities beyond T2D, and where are these gaps most evident across primary care, cardiology, nephrology, and endocrinology?
- What recommendations would you make to improve testing uptake?
The discussion highlights that while routine panels often include eGFR, lipid panels, and hemoglobin A1c, these tests alone do not capture the full scope of kidney risk, making uACR an essential complement. Panelists explain the practicalities of uACR testing, including using a quantitative lab measurement rather than a simple urine dip, and addressing factors like hydration, exercise, and timing to ensure accuracy. They stress repeating a positive uACR within three months to confirm a CKD diagnosis, paralleling the complementary roles of eGFR and uACR in assessing both kidney function and damage. The conversation also touches on barriers to implementation, such as clinician unfamiliarity and workflow challenges, while emphasizing that comprehensive testing is inexpensive, straightforward, and critical for identifying patients at latent risk. Overall, the panel underscores that missing uACR testing is akin to checking only part of a vital sign—it leaves the clinician with an incomplete picture and potentially misses opportunities for early intervention.
In the next episode, ‘uACR and eGFR Testing in CKD: Addressing Barriers and Patient Communication,’ panelists will continue their discussion on chronic kidney disease and highlight operational and behavioral hurdles to CKD screening, ranging from a "not my lane" mentality to the common misconception that a standard urine dipstick is a sufficient substitute for uACR testing. They advocate for overcoming clinical inertia by integrating eGFR and uACR into comprehensive cardiovascular risk assessments, specifically utilizing the KDIGO heat map as a tool to communicate systemic vascular health to patients.
