Frequency of screening see more 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. Kinase Inhibitor Library purchase 6. Screening for cardiovascular disease risk It is recommended that cardiovascular disease risk factors should be screened in all patients with CKD. “
“Date written: April 2009 Final submission: April 2009 Kidney status in people with type 2 diabetes should be assessed by: (Grade B)* a. Annual screening for albuminuria by: AER 30–300 mg/24 h or AER 20–200 µg/min in timed collection Macroalbuminuria
is indicated by: AER > 300 mg/24 h or AER > 200 µg/min in timed collection OR Albumin: Creatinine Ratio (ACR) – spot urine sample. Microalbuminuria is indicated by: ACR 2.5–25 mg/mmol in males ACR 3.5–35 mg/mmol in females Macroalbuminuria is indicated by: ACR > 25 mg/mmol in males ACR > 35 mg/mmol in females If AER or ACR screening is positive for microalbuminuria: Perform additional ACR or AER measurements one to two times within 3 months. Microalbuminuria is confirmed if at least two
of three tests (including the screening test) are positive. If AER or ACR screening is positive for macroalbuminuria: Perform a 24 h urine collection for quantitation either of protein excretion. AND eGFR < 60 mL/min per 1.73 m2 indicates at least moderate kidney dysfunction (Stage 3–5 chronic kidney disease [CKD]). eGFR 60–90 mL/min per 1.73 m2 may indicate mild kidney dysfunction (Stage 2 CKD if albuminuria also present). Continue annual screening for albuminuria and eGFR in the event of negative screening tests. Screening for microalbuminuria and glomerular filtration rate (GFR) should be preformed on an annual basis from the time of diagnosis of type 2 diabetes. This guideline topic has been taken from the NHMRC ‘National Evidence Based Guidelines for Diagnosis, Prevention and Management of CKD in type 2 diabetes’ which can be found in full at the CARI website (http://www.cari.org.au). The NHMRC guideline covers issues related to the assessment and prevention of CKD in individuals with established type 2 diabetes.