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screening-diagnosis

Less than 20% of at-risk patients receive complete, guideline-recommended CKD testing2*

Elevated uACR or reduced eGFR are independently associated with a higher risk of CV death and kidney disease progression, which is why guidelines recommend screening using both tests3,4

Key-Fact-1
Spot urine for uACR to detect albuminuria
Key-Fact-2
Blood test for serum creatinine to determine eGFR

If any abnormalities are present, retest eGFR and uACR after 3 months to  confirm CKD diagnosis5,6

 

*Based on a study by LabCorp and the National Kidney Foundation. Complete CKD testing defined as both eGFR and uACR. Lack of complete testing was driven primarily by absence of uACR (79%).

AE=adverse event; CKD=chronic kidney disease; CV=cardiovascular; DKA=diabetic ketoacidosis; eGFR=estimated glomerular filtration rate; GMI=genital mycotic infection; SGLT2=sodium-glucose cotransporter 2; SU=sulfonylurea; T1D=type 1 diabetes; T2D=type 2 diabetes; UTI=urinary tract infection.

Diabetes and hypertension are the top 2 risk factors for CKD7

Other risk factors include:

key-1
Obesity8
key-2
Family history8
key-3
Heart disease/stroke8,9
key-4
>60 years old10
key-5
Dyslipidaemia6
key-6
Tobacco use8
key-7
Low socioeconomic status & poor access to healthcare9,10

Take the opportunity to treat CKD early and maintain kidney function for as long as possible

Guidelines recommend initiating treatment for patients with moderately to severely increased uACR, regardless of eGFR stage5,6,11

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Screening-diagnosis-placeholder

Depending on risk level, the recommended screening frequency will vary

Screening Frequency

1 = once a year

2 = twice a year (every 6 months)


3 = 3 times a year (every 4 months)


4+ = 4 times a year or more (every 3 months or more)

Treat and Refer

Treat = provide guideline-based treatment


Refer = refer to nephrologist

Adapted from the 2022 American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) Consensus Report.

KDIGO Clinical Practice Guideline recommendations support the use of SGLT2is like JARDIANCE for appropriate patients5

CKD=chronic kidney disease; CV=cardiovascular; eGFR=estimated glomerular filtration rate; uACR=urinary albumin-to-creatinine ratio.

For more information, please see Prescribing Information.

References

  1. Shlipak MG, Tummalapalli SL, Boulware LE, et al. The case for early identification and intervention of chronic kidney disease: Conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) controversies conference. Kidney Int. 2021;99(1):34-37.

  2. Alfego D, Ennis J, Gillespie B, et al. Chronic kidney disease testing among at-risk adults in the U.S. remains low: real-world evidence from a national laboratory database. Diabetes Care. 2021;44(9):2025-2032. doi:10.2337/dc21-0723.

  3. Kidney failure risk factor: urine albumin-to-creatinine ratio (UACR). National Kidney Foundation. Accessed August 21, 2023. https://www.kidney.org/ content/kidney-failure-risk-factor-urine-albumin-to-creatinine-ration-uacr

  4. Kidney failure risk factor: estimated glomerular filtration rate (eGFR). National Kidney Foundation. Accessed August 21, 2023. https://www.kidney.org/content/kidney-failure-risk-factor-estimated-glomerular-filtration-rate-egfr

  5. Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group. KDIGO 2022 clinical practice guideline for diabetes management in chronic kidney disease. Kidney Int. 2022;102(5S):S1-S127.

  6. Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int Suppl. 2013;3(1):1-150.

  7. Introduction to your kidneys. American Kidney Fund. Accessed June 5, 2023. https://www.kidneyfund.org/all-about-kidneys/introduction-your-kidneys

  8. Chronic kidney disease. Mayo Clinic. September 3, 2021. Accessed June 5, 2023. https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/symptoms-causes/syc-20354521

  9. Chronic kidney disease in the United States, 2021. Center for Disease Control and Prevention. Updated July 12, 2022. Accessed June 5, 2023. https://www.cdc.gov/kidneydisease/publications-resources/ckd-national-facts.html

  10. Race, ethnicity, & kidney disease. National Kidney Foundation. Accessed June 5, 2022. https://www.kidney.org/atoz/content/minorities-KD#:~:text=Yes%2C%20one%20in%20three%20people

  11. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. Kidney Int. 2024;105 (Suppl. 4S):S117-S314

Disclaimer

Picture/s used in this communication is/are of professional actors/models, used for representation/creative purposes, and are not of any actual patient or healthcare professional. Any resemblance to persons, living or dead is coincidental. Boehringer Ingelheim India Pvt. Ltd. neither owns the images nor is affiliated with the actors/models.