As the US Preventive Services Task Force (USPSTF) considers chronic kidney disease (CKD) screening in primary care, experts are emphasizing earlier identification with both estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (uACR). Modeling suggests that screening adults aged 35 to 75 for albuminuria, followed by available treatment, could be cost-effective and potentially prevent up to 658,000 cases requiring dialysis or kidney transplantation. Yet major detection gaps remain: nearly 1 in 3 adults with severe CKD are unaware they have the disease, and in a study of more than 513,000 adults with type 2 diabetes, median annual testing rates were 89.5% for eGFR but only 52.9% for uACR. Because albuminuria may identify kidney damage while eGFR remains relatively preserved, using both measures could shift CKD detection from late-stage presentation toward earlier, asymptomatic case-finding.

A future screening recommendation could extend beyond patients with diabetes and hypertension to other higher-risk groups, including adults with cardiovascular disease, obesity, older age, or a family history of kidney disease. Implementation may be as important as test availability: a 2025 American Kidney Fund survey found that although 68% of respondents had undergone an annual physical in the previous year, only 51% said their kidneys were checked and just 5% recalled ever receiving a uACR test. Incorporating kidney assessment into routine cardiovascular-kidney-metabolic preventive care could help clinicians identify disease earlier, confirm abnormal findings, and initiate guideline-directed therapy when there is greater opportunity to preserve kidney function. Importantly, the USPSTF has not yet issued a draft CKD screening recommendation, so these proposals represent expert perspective and modeling evidence rather than current Task Force guidance.

Reference: Garimella P. The case for routine kidney screening, with Pranav Garimella, MBBS, MPH. HCP Live. Published September 25, 2026. Accessed October 6, 2026. https://www.hcplive.com/view/the-case-for-routine-kidney-screening-with-pranav-garimella-mbbs-mph

Link: https://www.hcplive.com/view/the-case-for-routine-kidney-screening-with-pranav-garimella-mbbs-mph