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)
2011
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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