Chronic kidney disease (CKD) affects about 1 in 7 US adults, yet approximately 90% of patients are unaware they have it—and even among those with stage 4 CKD, only about half know their diagnosis. Because CKD is often asymptomatic, missed detection represents an important opportunity to intervene before kidney failure or cardiovascular complications develop. Accurate identification and staging require both estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (uACR), since lower eGFR and higher albuminuria are associated not only with kidney disease progression but also with greater cardiovascular morbidity and mortality. This connection reinforces CKD as a central component of cardio-kidney-metabolic risk rather than an isolated renal condition.
Primary care clinicians carry much of the responsibility for CKD screening, but competing preventive and chronic-care demands can make consistent testing difficult. Population health strategies may help close that gap by using electronic health record alerts, automated health-maintenance prompts, dashboards, and other clinical decision-support tools to identify high-risk patients who are missing eGFR or uACR testing. Patients with diabetes are an especially important target because approximately 40% develop CKD, yet many remain undiagnosed. More automated approaches—including system-generated testing reminders or bulk ordering—could reduce clinician workload, standardize screening, and help identify CKD earlier, when there is greater opportunity to slow progression and reduce downstream cardiovascular and kidney risk.
Reference: Jhamb M. Addressing the challenges of undiagnosed chronic kidney disease. AJMC. 2026 May 12.
Link: https://www.ajmc.com/view/addressing-the-challenges-of-undiagnosed-chronic-kidney-disease
